NPIMap

Organization Active NPI

Just Divine Homecare Agency LLC

  • In Home Supportive Care Agency
  • Clarksburg, MD
National Provider Identifier
1285958454
Registry record updated Mar 17, 2010
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Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
R2617 Issued in MD
Legal business name
JUST DIVINE HOMECARE AGENCY LLC
Practice address
23004 Winged Elm Dr
Clarksburg, MD 20871-4468
Phone
(301) 219-1585
Fax
(240) 241-5181
NPI assigned
Mar 17, 2010
Last updated
Mar 17, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Ms. Priscilla O Andoh
Title
Administrator
Phone
(301) 219-1585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X R2617 MD Primary

Addresses

Primary practice location

23004 Winged Elm Dr
Clarksburg, MD 20871-4468

Mailing address

23004 Winged Elm Dr
Clarksburg, MD 20871-4468
Phone (301) 219-1585

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1285958454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23004 WINGED ELM DR",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714468",
            "telephone_number": "301-219-1585",
            "fax_number": "240-241-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23004 WINGED ELM DR",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714468",
            "telephone_number": "301-219-1585",
            "fax_number": "240-241-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST DIVINE HOMECARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "ANDOH",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-219-1585",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MD",
            "license": "R2617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.