Divine Home Care

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

DIVINE HOME CARE

Practice address

802 Grant St Apt 3
Dothan, AL 36301-3807

Phone

(334) 405-5881

NPI assigned

Aug 27, 2014

Organization subpart

No

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

Authorized official

Name

Derrick O Tiller

Title

Owner

Phone

(334) 405-5881

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1487054300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 GRANT ST APT 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013807",
            "telephone_number": "334-405-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 GRANT ST APT 3",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013807",
            "telephone_number": "334-405-5881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "TILLER",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-405-5881"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorthea F Diaz, CRNA
• Jamie Brianne Diaz
• Elizabeth Bentley Dickard, M.A. CCC-SLP
• Dianne White Dimick
• Shelby Elizabeth Dipilla, BCBA
• Jon A Dix, CRNA
• Anna Paige Dixon, ALC
• Tracy N. Dixon, LMT
• DMJ Enterprises Dba/Access in-Home Services
• Jessica A Domm, PHARMD

• Adult Care Home Facility in Dothan, AL
• Providers in Dothan, AL by specialty
• Adult Care Home Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.