Care Divinity Health Services LLC.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CARE DIVINITY HEALTH SERVICES LLC.

Practice address

6735 I 55 S Ste 6
Byram, MS 39272-9162

Phone

(601) 809-3940

NPI assigned

Apr 8, 2024

Last updated

Apr 8, 2024By 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

Valknekah Bullie

Title

Ceo

Phone

(601) 809-3940

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1154174332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 I 55 S STE 6",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729162",
            "telephone_number": "601-809-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 I 55 S STE 6",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392729162",
            "telephone_number": "601-809-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE DIVINITY HEALTH SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "BULLIE",
        "authorized_official_first_name": "VALKNEKAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-809-3940"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.