OrganizationActive
Divine Providence Village
NPI 1609993294 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Philadelphia, PA
Provider details
- NPI number
- 1609993294
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dawn Engel, Hipaa Officer(610) 525-8800
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1130 Custis Pl
Philadelphia, PA 19122-4108
Phone: (610) 543-5410
Fax: (610) 543-5397
Street-level locationGet directions
Mailing address
686 Old Marple Rd
Springfield, PA 19064-1239
Registry dates
- Enumerated
- 2007-03-26
- Last updated
- 2024-04-05
- Certified
- 2024-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.