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DIVINE PROVIDENCE VILLAGE
NPI 1063530756
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Philadelphia, PA

Active since March 27, 2007
1804 DALLAS ST, PHILADELPHIA, PA 19126(610) 543-5410(610) 543-5397 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Divine Providence Village NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINE PROVIDENCE VILLAGE (NPI 1063530756) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Philadelphia, Pennsylvania and active in the NPI registry since March 2007. The organization lists Dawn Engel, Hipaa Officer, as its authorized official.

NPPES Registry Identity

NPI1063530756
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameDIVINE PROVIDENCE VILLAGE
Location Address1804 DALLAS STPhiladelphia, PA 19126-1519
Mailing Address686 Old Marple RdSpringfield, PA 19064-1239 · (610) 328-7730 · Fax (610) 544-1710
Phone(610) 543-5410
Fax(610) 543-5397
Organization SubpartNo
Authorized OfficialDawn EngelHipaa Officer · (610) 525-8800
Enumeration DateMarch 27, 2007
Last NPPES UpdateMarch 28, 2024
NPPES CertifiedMarch 28, 2024
✔ NPI 1063530756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
1804 DALLAS ST, Philadelphia, PA 19126
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Other Identifiers 1

Medicaid1000031590092PA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divine Providence Village's NPI number?

The NPI number for Divine Providence Village is 1063530756. It was assigned to this organization in the NPPES registry on March 27, 2007.

Where is Divine Providence Village located?

Divine Providence Village is located at 1804 Dallas St, Philadelphia, PA 19126. The listed phone number is (610) 543-5410.

What is Divine Providence Village's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Divine Providence Village was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.