Divine Grace in-Home & Private Healthcare Service

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC4729 Issued in NC

Legal business name

DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE

Doing business as

divine grace in-home & private healthcare service

Practice address

3535 S Wilmington St Ste 202
3535 South Wilmington Street Suite 202
Raleigh, NC 27603-3512

Phone

(919) 796-0734

NPI assigned

Feb 19, 2015

Organization subpart

Yes

Parent organization

DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICEAs reported in NPPES

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

Authorized official

Name

David Jr Griffin

Title

Owner

Phone

(919) 796-0734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• divine grace in-home & private healthcare service Doing business as

Locations

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1083006647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S WILMINGTON ST STE 202",
            "address_2": "SUITE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033512",
            "telephone_number": "919-796-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S WILMINGTON ST STE 202",
            "address_2": "3535 SOUTH WILMINGTON STREET SUITE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276033512",
            "telephone_number": "919-796-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-796-0734"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC4729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150081",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "divine grace in-home & private healthcare service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Traci Annette Diveley, PTA
• Divine Destiny Development L.L.C.
• Divine Grace Home Care
• Divine Grace Homecare Services, LLC
• Divine Grace Homecare Services, LLC
• Divine Healthcare, Inc.
• Divine Legends LLC
• Divine Medical Equipment Supplies, Inc.
• Divine Supportive Homes Inc
• Prashant Pramodkumar Diwan

• 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 Feb 19, 2015; 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.