Dynasty Diverse Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DYNASTY DIVERSE SERVICES, LLC

Practice address

211 Julian Pond LN
Kernersville, NC 27284-2461

Phone

(336) 462-7275

NPI assigned

Apr 10, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Thomina McNair-Mills

Title

Managing Member

Phone

(336) 462-7275

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1356584023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 JULIAN POND LN",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842461",
            "telephone_number": "336-462-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 JULIAN POND LN",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842461",
            "telephone_number": "336-462-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNASTY DIVERSE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-10",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "MCNAIR-MILLS",
        "authorized_official_first_name": "THOMINA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "336-462-7275",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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 Mar 29, 2011; 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.