Providence Living LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Media, Pennsylvania
1730562711- Practice location
- 280 N Providence RD Ste 2, Media, PA 19063-3525
- Phone
- 484-445-4145
- Fax
- 888-373-9844
- Last updated
- August 25, 2025
Providence Living LLC is a healthcare organization based in Media, PA. Providence Living LLC practices in Media, PA. The NPI Number for Providence Living LLC is 1730562711 and holds a License No. 237095 (PA). The current practice location address for Providence Living LLC is 280 N Providence RD Ste 2, Media, PA 19063-3525 and can be reached out via phone at 484-445-4145 and via fax at 888-373-9844.
Provider Profile Details
- NPI Number
- 1730562711
- Provider Name
- Providence Living LLC
- Provider Entity Type
- Organization
- Address
- 280 N Providence RD Ste 2, Media, PA 19063-3525
- Phone Number
- 484-445-4145
- Fax Number
- 888-373-9844
- Primary Taxonomy
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X
- Organization Subpart
- No
- Authorized Official
- Dr. William J Heran, PHD, LCSW · Ceo · 484-445-4145
- Other Names
- Providence Treatment (Doing Business As)
Providence Treatment (Other Name) - Provider Enumeration Date
- July 8, 2015
- Last Update Date
- August 25, 2025
- Certification Date
- August 25, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 280 N Providence RD Ste 2
Media, PA 19063-3525 - City
- Media
- State
- Pennsylvania
- Zip
- 19063-3525
- Phone Number
- 484-445-4145
- Fax Number
- 888-373-9844
Provider Business Mailing Address Details
- Address
- 280 N Providence RD Ste 2
Media, PA 19063-3525 - City
- Media
- State
- PA
- Zip
- 19063-3525
- Phone Number
- 484-445-4145
- Fax Number
- 888-373-9844
License Information
- License Number (1)
- 237095
- License State (1)
- PA
- Taxonomy (1)
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- Taxonomy (2)
- Counselor, Mental Health · 101YM0800X
- Taxonomy (3)
- Clinic/Center, Adult Mental Health · 261QM0850X
- License Number (4)
- 237095
- License State (4)
- PA
- Taxonomy (4)
- Substance Abuse Rehabilitation Facility · 324500000X
- Taxonomy (5)
- Clinic/Center, Rehabilitation, Substance Use Disorder · 261QR0405X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Clinic/Center, Rehabilitation, Substance Use Disorders near Media, PA
View all Clinic/Center, Rehabilitation, Substance Use Disorders in Media →Frequently Asked Questions
What is the NPI number of Providence Living LLC?
The NPI number of Providence Living LLC is 1730562711. It was assigned on July 8, 2015 and is currently active in the NPPES registry.
What is the specialty of Providence Living LLC?
Providence Living LLC is registered under the primary taxonomy Clinic/Center, Rehabilitation, Substance Use Disorder (code 261QR0405X), licensed in PA under license number 237095.
Where does Providence Living LLC practice?
The practice location is 280 N Providence RD Ste 2, Media, PA 19063-3525. The office can be reached at 484-445-4145 (phone) or 888-373-9844 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1730562711 directly on the NPPES registry website.