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DIVINE PROVIDENCE VILLAGE
NPI 1396864971
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Philadelphia, PA

Active since March 28, 2007
6610 N 12TH ST, PHILADELPHIA, PA 19126(610) 543-5410(610) 543-5397 Get Directions Write a Review

NPPES record last updated: April 2, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 2, 2024, Nov 17, 2015 (2 updates tracked since 2015).

About Divine Providence Village NPPES

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

DIVINE PROVIDENCE VILLAGE (NPI 1396864971) 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

NPI1396864971
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameDIVINE PROVIDENCE VILLAGE
Location Address6610 N 12TH STPhiladelphia, PA 19126-3201
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 28, 2007
Last NPPES UpdateApril 2, 20242 updates tracked since enumeration
NPPES CertifiedApril 2, 2024
✔ NPI 1396864971 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.

6610 N 12TH ST, Philadelphia, PA 19126
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Other Identifiers 1

Medicaid1000031590094PA

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 1396864971. It was assigned to this organization in the NPPES registry on March 28, 2007.

Where is Divine Providence Village located?

Divine Providence Village is located at 6610 N 12th 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 April 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.