Organization
PROVIDENCE LIVING LLC
Active
Other names
Providence Treatment, Providence Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J HERAN PHD, LCSW (CEO)
(484) 445-4145
Entity
Organization
Contact information
Practice address
280 N PROVIDENCE RD STE 2, MEDIA, PA 19063-3525
(484) 445-4145
(888) 373-9844
Mailing address
280 N PROVIDENCE RD STE 2, MEDIA, PA 19063-3525
(484) 445-4145
(888) 373-9844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
237095
PA
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
237095
PA
Other
Enumeration date
07/08/2015
Last updated
08/25/2025
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