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Provider Demographic Information - KENSINGTON COMMUNITY CORP FOR INDIVIDUAL DIGNITY

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	KENSINGTON COMMUNITY CORP FOR INDIVIDUAL DIGNITY
Address:	9350 ASHTON RD Ste 202 PHILADELPHIA, PA 19114-3400
Phone:	(215) 288-9797
Fax:	(215) 288-9883
E-mail:	maria.bandrivsky@kenccid.org
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Bucks
\|Service Name / Level	\|Rate

Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Montgomery
\|Service Name / Level	\|Rate

Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Philadelphia
\|Service Name / Level	\|Rate

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
Needs Exception Allowance (NEA)-Adult Res (6400)	$0.01 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$0.01 - $1,382.67 / 1 Day
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 1-Elig	$387.76 / 1 Day
Res Hab-3 Person-NG 1-Elig-w/Day Supports	$294.49 / 1 Day
Res Hab-3 Person-NG 2-Elig	$441.87 / 1 Day
Res Hab-3 Person-NG 2-Elig-w/Day Supports	$341.21 / 1 Day
Res Hab-3 Person-NG 3-Elig	$514.20 / 1 Day
Res Hab-3 Person-NG 3-Elig-w/Day Supports	$440.90 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Res Hab-Lic-3 Person-Inelig	$38.74 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Eligible)	$132.49 / 1 Day
Resid Hab-Unlic 1-Indiv Home (Inelig)	$26.69 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.
Supported Emplymnt-Career Assessment	$17.91 / 15 min.
Supported Emplymnt-Job Finding/Job Development	$17.91 / 15 min.
Supported Emplymnt-Job Support - 1:1	$17.91 / 15 min.
Supported Emplymnt-Job Support-1:2	$10.72 / 15 min.

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