Divine Community Care Providers, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE COMMUNITY CARE PROVIDERS, LLC

Practice address

7550 Slate Ridge Blvd
Reynoldsburg, OH 43068-3156

Phone

(614) 861-0861

Fax

(614) 861-8026

NPI assigned

Oct 3, 2008

Last updated

Oct 3, 2008By 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

Ms. Angelique Maria Porter

Title

President

Phone

(614) 861-0861

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1134370513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683156",
            "telephone_number": "614-861-0861",
            "fax_number": "614-861-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683156",
            "telephone_number": "614-861-0861",
            "fax_number": "614-861-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE COMMUNITY CARE PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-861-0861",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2649227",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBS CONTRACT NUMBER",
            "identifier": "2531853",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Endia Dickson, CHP
• Tameka Denise Dillard-O'Neal, RN
• Katelyn Dipasquale
• Distinguished Home Services LLC
• Divine & Favor Residential Care Services, LLC
• Divine Community Healthcare Services, LLC
• Divine Family Dentistry
• Divine Transport Service LLC
• Divine-Favor Home Care Agency LLC
• Ayafor Divine

• Home Health Agency in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.