Divergent Recovery LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DIVERGENT RECOVERY LLC

Practice address

15655 W Roosevelt St Ste 100
Goodyear, AZ 85338-9311

Phone

(480) 336-0507

NPI assigned

Aug 10, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Garrett Deetz

Title

Owner

Phone

(480) 336-0507

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1104554864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 W MISSION LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853454829",
            "telephone_number": "480-336-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15655 W ROOSEVELT ST STE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389311",
            "telephone_number": "480-336-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGENT RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "DEETZ",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-336-0507",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "g.deetz42@gmail.com",
            "affiliation": "N",
            "address_1": "15655 W Roosevelt St Ste 100",
            "city": "Goodyear",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853389311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer S Dimas, WHNP-BC
• Jocelyn Abueva Dimeco, FNP
• Jeremy R Ding, PHARMD
• Sarah Marie Disney
• Conrad Franklin Diven, MD
• Divine Assurance Behavioral Health Residentail Care LLC
• Divine Assurance Behavioral Health Residentail Care LLC
• Divine Interventional Psychiatry PLLC
• Corinne Dixon
• Steven DO, RPH

• Community/Behavioral Health Agency in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.