NPIMap

Organization Active NPI

Divinity'S Residential Service

  • Early Intervention Provider Agency
  • Canton, OH
National Provider Identifier
1497524250
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
DIVINITY'S RESIDENTIAL SERVICE
Practice address
2814 Vienna View CT SW
Canton, OH 44706-5629
Phone
(330) 639-8258
NPI assigned
Dec 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Tammi R NelsonNPI 1417726274
Title
Owner
Phone
(330) 639-8258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

2814 Vienna View CT SW
Canton, OH 44706-5629

Mailing address

2814 Vienna View CT SW
Canton, OH 44706-5629
Phone (330) 639-8258

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1497524250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 VIENNA VIEW CT SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447065629",
            "telephone_number": "330-639-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 VIENNA VIEW CT SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447065629",
            "telephone_number": "330-639-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINITY'S RESIDENTIAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TAMMI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-639-8258"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.