PROVIDENCE LIVING LLC NPI 1730562711

NPI Information

  • NPI: 1730562711
  • Provider Name: PROVIDENCE LIVING LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Doing Business As: PROVIDENCE TREATMENT
  • Address: 280 N PROVIDENCE RD STE 2
    MEDIA, PA
    ZIP 19063
  • Phone: (484) 445-4145

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NPI Details

PROVIDENCE LIVING LLC is a substance abuse rehabilitation facility in Media, PA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PROVIDENCE LIVING LLC NPI is 1730562711. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Treatment.

The provider's business location address is:

280 N PROVIDENCE RD STE 2
MEDIA, PA
ZIP 19063-525
Phone: (484) 445-4145
Fax: (888) 373-9844

The provider's authorized official is William J Heran .
The authorized official title is Ceo and has the following contact phone number (484) 445-4145.

The enumeration date for this NPI number is 7/8/2015 and was last updated on 9/3/2024.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)237095PENNSYLVANIANo
2261QM0850XClinic/CenterAdult Mental HealthNo
3324500000XSubstance Abuse Rehabilitation Facility237095PENNSYLVANIAYes

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: 3/30/2025

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