PROVIDENCE LIVING LLC

PHILADELPHIA, PA
NPI1962965145
Entity TypeOrganization
Authorized ContactWILLIAM HERAN
CEO
484-445-4145
Organization Subpart ?No
Primary Taxonomy261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder
Additional Taxonomies101YA0400X Counselor Addiction (Substance Use Disorder)
101YM0800X Counselor Mental Health
261QM0850X Clinic/Center Adult Mental Health
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date2019-04-13
Last Update Date2025-08-25
Business Address
PROVIDENCE LIVING LLC
1528 WALNUT ST STE 1410
PHILADELPHIA, PA 19102-3610
Phone number: 484-445-4145
Mailing Address
PROVIDENCE LIVING LLC
1528 WALNUT ST STE 1410
PHILADELPHIA, PA 19102-3610
Phone number: 484-445-4145