DIVINE SUPPORTS SERVICES NPI 1669924866

NPI Information

  • NPI: 1669924866
  • Provider Name: DIVINE SUPPORTS SERVICES
  • Classification: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization - 251T00000X
  • Entity Type: Organization
  • Address: 3954 STRATFORD RD
    DREXEL HILL, PA
    ZIP 19026
  • Phone: (484) 358-5535

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NPI Details

DIVINE SUPPORTS SERVICES is a program of all inclusive care for the elderly pace provider organization in Drexel Hill, PA. The provider is a PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. DIVINE SUPPORTS SERVICES NPI is 1669924866. The provider is registered as an organization entity type.

The provider's business location address is:

3954 STRATFORD RD
DREXEL HILL, PA
ZIP 19026-723
Phone: (484) 358-5535

The provider's authorized official is Olufunmilayo Balogun-victor .
The authorized official title is Ceo and has the following contact phone number (484) 358-5535.

The enumeration date for this NPI number is 11/4/2016 and was last updated on 5/3/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251J00000XNursing CareRN600719PENNSYLVANIANo
2251T00000XProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationRN600719PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1103220771OTHERPENNSYLVANIAODP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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