| NPI | 1083478325 |
|---|---|
| Doing Business As | DIVINE PROVIDENCE HEALTHCARE, LLC |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN NWANONENYI CEO 215-954-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |