Divine Care of Port Charlotte

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

DIVINE CARE OF PORT CHARLOTTE

Practice address

2532 Starlite LN
Port Charlotte, FL 33952-5653

Phone

(941) 626-5409

Fax

(941) 235-8770

NPI assigned

Aug 23, 2021

Last updated

Aug 23, 2021By 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

Marvet A Flowers DavisNPI 1417437559

Title

Administrator

Phone

(941) 626-5409

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, and the practitioner matching its NPPES authorized official.

• Marvet A Flowers-Davis

  • Nurse's Aide
  • Port Charlotte, FL
  • NPI 1417437559
  NPD Authorized official

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1235805847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 STARLITE LN",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525653",
            "telephone_number": "941-626-5409",
            "fax_number": "941-235-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 STARLITE LN",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525653",
            "telephone_number": "941-626-5409",
            "fax_number": "941-235-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CARE OF PORT CHARLOTTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "FLOWERS DAVIS",
        "authorized_official_first_name": "MARVET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-626-5409"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Behavioral Disturbances) in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Assisted Living Facility (Behavioral Disturbances) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.