Divine Living Alf Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12360 Issued in FL

Legal business name

DIVINE LIVING ALF INC

Practice address

471 Neptune Dr NE
Palm Bay, FL 32907-1508

Phone

(321) 622-4615

NPI assigned

Jun 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nadji D Williams

Title

Administrator

Phone

(321) 622-4615

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1003254053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 DECATUR CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347290",
            "telephone_number": "321-622-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 NEPTUNE DR NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329071508",
            "telephone_number": "321-622-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE LIVING ALF INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NADJI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-622-4615",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "12360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark C Dillon, MD
• Tram Dinh
• Erika Diogene, D.O.
• Laura L Dion, LCSW
• Diversify Reliable Transportation LLC
• Divine Wellness Partners, LLC
• Doctors Gi Partnership LTD
• Tracey Aileen Doherty, CCC-SLP
• Jeanette Donaldson
• Dong Yo Acupuncture

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.