Divine Care

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

DIVINE CARE

Practice address

2500 W Broadway
Louisville, KY 40211-1081

Phone

(502) 523-2347

NPI assigned

Dec 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Kwane Mitchell Watson

Title

Owner

Phone

(502) 523-2347

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1346661949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-523-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111081",
            "telephone_number": "502-523-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-27",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KWANE",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-523-2347",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter David Distler, DMD
• Kathleen Ann Dively, ARNP
• Diversicare Highlands, LLC
• Diversicare of Seneca Place LLC
• Diversified Patient Resources, Inc.
• Divine Residential Care Services
• Divine Steps Inc.
• Divine Steps Inc.
• Marissa Grace Dix, BS, RBT
• Nannette Bertram Dix, CSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.