Organization Active NPI

Living Divine Home Care LLC

  • In Home Supportive Care Agency
  • Philadelphia, PA
National Provider Identifier
1053075259
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LIVING DIVINE HOME CARE LLC
Practice address
2455 W Sergeant St
Philadelphia, PA 19132-4135
Phone
(215) 399-2788
NPI assigned
Oct 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Moania Wilks-Devine
Title
Owner / President
Phone
(215) 866-8177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2455 W Sergeant St
Philadelphia, PA 19132-4135

Mailing address

2455 W Sergeant St
Philadelphia, PA 19132-4135

National Provider Directory

National Provider Directory

Locations

2455 W Sergeant St
Philadelphia, PA 19132
Phone (215) 399-2788

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1053075259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 W SERGEANT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191324135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 W SERGEANT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191324135",
            "telephone_number": "215-399-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING DIVINE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "WILKS-DEVINE",
        "authorized_official_first_name": "MOANIA",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "215-866-8177"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.