Divine Grace Homecare Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

DIVINE GRACE HOMECARE SERVICES, LLC

Practice address

189 Wind Chime CT
Raleigh, NC 27615-6479

Phone

(919) 247-9158

NPI assigned

Sep 15, 2021

Organization subpart

No

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

Authorized official

Name

Matondo Chantal Soko

Title

Owner

Phone

(919) 247-9158

Specialties & licenses 1

Addresses

Tax ID family

Divine Grace Homecare Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Divine Grace Homecare Services, LLC

  • In Home Supportive Care Agency
  • Raleigh, NC
  • NPI 1992477558
  NPD tax ID

Locations

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1154091858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 WIND CHIME CT STE 104F",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156479",
            "telephone_number": "919-247-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 WIND CHIME CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156479",
            "telephone_number": "919-247-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GRACE HOMECARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "SOKO",
        "authorized_official_first_name": "MATONDO",
        "authorized_official_middle_name": "CHANTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-247-9158"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Denise Dittmer, M.D., MPH, MS
• Joshua Eugene Dittmer, M.D.
• Traci Annette Diveley, PTA
• Divine Destiny Development L.L.C.
• Divine Grace Home Care
• Divine Grace Homecare Services, LLC
• Divine Grace in-Home & Private Healthcare Service
• Divine Healthcare, Inc.
• Divine Legends LLC
• Divine Medical Equipment Supplies, Inc.

• In Home Supportive Care Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• In Home Supportive Care Agency in North Carolina

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