Divine Healthcare, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC-3018 Issued in NC

Legal business name

DIVINE HEALTHCARE, INC.

Practice address

1001 Navaho Dr
Suite 203-B
Raleigh, NC 27609-7335

Phone

(919) 881-8041

Fax

(919) 881-8316

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Martin Osagie, PRESIDENT

Title

Agency Director

Phone

(919) 881-8041

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1003993197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NAVAHO DR",
            "address_2": "SUITE 203-B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097335",
            "telephone_number": "919-881-8041",
            "fax_number": "919-881-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NAVAHO DR",
            "address_2": "SUITE 203-B",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097335",
            "telephone_number": "919-881-8041",
            "fax_number": "919-881-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "OSAGIE",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "919-881-8041",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC-3018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340-8383",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660-1281",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Destiny Development L.L.C.
• Divine Grace Home Care
• Divine Grace Homecare Services, LLC
• Divine Grace Homecare Services, LLC
• Divine Grace in-Home & Private Healthcare Service
• Divine Legends LLC
• Divine Medical Equipment Supplies, Inc.
• Divine Supportive Homes Inc
• Prashant Pramodkumar Diwan
• Doyle Thomas Dix Jr., CRNA

• Home Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.