| Providence Living Llc | |
|
1528 Walnut St Ste 1410 Philadelphia PA 19102-3610 | |
| (484) 445-4145 | |
| (888) 373-9844 |
| Full Name | Providence Living Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1528 Walnut St Ste 1410, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | William Heran (CEO) |
| Authorized Official Contact | 4844454145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Living Llc 1528 Walnut St Ste 1410 Philadelphia PA 19102-3610 Ph: (484) 445-4145 | Providence Living Llc 1528 Walnut St Ste 1410 Philadelphia PA 19102-3610 Ph: (484) 445-4145 |
| NPI Number | 1962965145 |
|---|---|
| Provider Enumeration Date | 04/13/2019 |
| Last Update Date | 08/25/2025 |
| Certification Date | 08/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962965145 | NPI | - | NPPES |
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