Divine Connection LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

License

2002 Issued in MS

Legal business name

DIVINE CONNECTION LLC

Practice address

442 Highway 1 S
Greenville, MS 38701-4901

Phone

(662) 219-8409

NPI assigned

Apr 19, 2017

Last updated

Apr 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laquanda Watson

Title

Director/Manager

Phone

(662) 219-8409

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1013441658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 STONE ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387033451",
            "telephone_number": "662-219-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 HIGHWAY 1 S",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014901",
            "telephone_number": "662-219-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CONNECTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "LAQUANDA",
        "authorized_official_title_or_position": "DIRECTOR/MANAGER",
        "authorized_official_telephone_number": "662-219-8409"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MS",
            "license": "2002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.