Organization
DIVINE PROVIDENCE HEALTHCARE, LLC
Active
Other names
Divine Providence HealthCare, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN NWANONENYI (CEO)
(215) 954-7181
Entity
Organization
Contact information
Practice address
515 W GIRARD AVE, PHILADELPHIA, PA 19123-1461
(215) 954-7181
Mailing address
515 W GIRARD AVE APT 1, PHILADELPHIA, PA 19123-1461
(215) 954-7181
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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