Truly Divine Home Care Agency, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

TRULY DIVINE HOME CARE AGENCY, LLC

Practice address

18 Cora St
River Rouge, MI 48218-1202

Phone

(313) 996-9111

NPI assigned

Jul 10, 2023

Last updated

Jul 10, 2023By 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

Delecia O ClarkNPI 1558049171

Title

Home Health Aid

Phone

(313) 996-9111

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.

• Delecia O Clark

  • In Home Supportive Care Agency
  • River Rouge, MI
  • NPI 1558049171
  NPD Authorized official

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1437837283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CORA ST",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181202",
            "telephone_number": "313-996-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CORA ST",
            "city": "RIVER ROUGE",
            "state": "MI",
            "postal_code": "482181202",
            "telephone_number": "313-996-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRULY DIVINE HOME CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DELECIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "HOME HEALTH AID",
        "authorized_official_telephone_number": "313-996-9111"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michon Scott
• William Abraham Shaheen III, O.D.
• Kimberly Nokole Smallwood, REGISTERED NURSE
• Sumpter Integrated Health Care Clinic P.L.L.C.
• Jonathan Leslie Tate, M.P.A.
• Rachel Wallner
• Yerevan Pharmacy Inc (Rouge Drug Store)

• In Home Supportive Care Agency in River Rouge, MI
• Providers in River Rouge, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.