NPIMap

Organization Active NPI

Divine Residential Services, LLC.

Doing business as Divine Transformation

  • Community/Behavioral Health Agency
  • Richmond, VA
National Provider Identifier
1528198025
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
89305001 Issued in VA
Legal business name
DIVINE RESIDENTIAL SERVICES, LLC.
Doing business as
Divine Transformation
Practice address
6206 Manuel CT
Richmond, VA 23234-5894
Phone
(804) 918-1433
NPI assigned
Mar 6, 2007
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Samara Gracia
Title
Executive Director
Phone
(804) 306-1242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 89305001 VA Primary

Addresses

Primary practice location

6206 Manuel CT
Richmond, VA 23234-5894

Mailing address

12501 Chesdin Landing Dr
Chesterfield, VA 23838-3230
Phone (804) 306-1242

Other names 1

  • Divine Transformation Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1528198025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CHESDIN LANDING DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383230",
            "telephone_number": "804-306-1242",
            "fax_number": "804-590-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6206 MANUEL CT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232345894",
            "telephone_number": "804-918-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE RESIDENTIAL SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "GRACIA",
        "authorized_official_first_name": "SAMARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-306-1242"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "89305001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Transformation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.