Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divine Providence Village

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1063530756

Divine Providence Village is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007

Practice location Address checks out

1804 Dallas St
Philadelphia, PA 19126-1519
Phone: (610) 543-5410
Fax: (610) 543-5397
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X (PA)

Record details

NPI number1063530756
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dawn Engel — Hipaa Officer · (610) 525-8800
NPI enumeratedMarch 27, 2007
Last updated in NPPESMarch 28, 2024
Certification dateMarch 28, 2024
Mailing address686 Old Marple Rd, Springfield, PA 19064-1239

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