Divine Health Services LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

DIVINE HEALTH SERVICES LLC

Practice address

107 Ashley Ave
Lakewood, NJ 08701-4212

Phone

(732) 367-6252

NPI assigned

Dec 27, 2017

Organization subpart

No

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

Authorized official

Name

Susan Plotnik, MS

Title

Director

Phone

(732) 367-6252

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1326554452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ASHLEY AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ASHLEY AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014212",
            "telephone_number": "732-367-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "PLOTNIK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-367-6252",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Dec 27, 2017; 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.