Divine Individualized Supports

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

DIVINE INDIVIDUALIZED SUPPORTS

Practice address

703 Arons Cir
Sewell, NJ 08080-2534

Phone

(856) 434-1856

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Khristopher InmanNPI 1609523869

Title

Ceo

Phone

(856) 434-1856

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khristopher Inman

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Sewell, NJ
  • NPI 1609523869

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1083336093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 ARONS CIR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802534",
            "telephone_number": "856-434-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 ARONS CIR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802534",
            "telephone_number": "856-434-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INDIVIDUALIZED SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "INMAN",
        "authorized_official_first_name": "KHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-434-1856"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Dimino
• Alfred M Dipiero, DO
• Daniel J Disabatino, PT
• Joseph Discienza, MPT
• Theresa Marie Ditizio, DPT
• Andrew Doberstein, DMD
• Brielle Dolan
• Kelly Donegan, APN
• Sohil Shailesh Doshi, MD
• Barbara Dougherty, D.O.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.