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Divine Providence Village
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Glenside, Pennsylvania
NPI 1801915418

Divine Providence Village is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Springfield, PA. Divine Providence Village practices in Glenside, PA. The NPI Number for Divine Providence Village is 1801915418 and holds a License No. (Pennsylvania).

The current practice location address for Divine Providence Village is 106 Woodlyn Ave, Glenside, PA and can be reached out via phone at 610-543-5410 and via fax at 610-543-5397.

Location: 106 Woodlyn Ave, Glenside, PA, 19064-1239
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1801915418
Provider Name
Divine Providence Village
Credential
Provider Entity Type
Organization
Address
106 Woodlyn Ave, Glenside, PA, 19064-1239
Phone Number
610-543-5410
Fax Number
610-543-5397
Provider Enumeration Date
03/28/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1000031590087 05 PA
institution
Provider Business Practice Location Address Details
Address
106 Woodlyn Ave
City
Glenside
State
Pennsylvania
Zip
19038-4743
Phone Number
610-543-5410
Fax Number
610-543-5397
person
Provider Business Mailing Address Details
Address
106 Woodlyn Ave
City
Glenside
State
Pennsylvania
Zip
19038-4743
Phone Number
610-543-5410
Fax Number
610-543-5397
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
(Pennsylvania)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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