PROVIDENCE LIVING LLC is a substance abuse rehabilitation facility in Philadelphia, 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 1962965145. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Treatment.
The provider's business location address is:
1528 WALNUT ST STE 1410
PHILADELPHIA, PA
ZIP 19102-610
Phone: (484) 445-4145
Fax: (888) 373-9844
The provider's authorized official is William Heran .
The authorized official title is Ceo and has the following contact phone number (484) 445-4145.
The CLIA number assigned to this NPI record is 39D2293372 - other - outpatient care with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/13/2019 and was last updated on 5/7/2021.