Divine Providence Village
NPI #1144685785 in Prospect Park, Pennsylvania
Provider Information
- NPI Number
- 1144685785
- Entity Type
- Organization
- Organization Name
- Divine Providence Village
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Dec 28, 2015
- Last Updated
- Mar 29, 2024
Practice Location
- Address
- 208 MACKENZIE AVE
- City
- Prospect Park
- State
- Pennsylvania
- ZIP Code
- 19076-2516
- Phone
- (610) 543-3380
Authorized Official
- Name
- DAWN ENGEL
- Title
- HIPAA OFFICER
- Phone
- (610) 525-8800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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