Organization Active NPI

Divine Charis Health Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Marlboro, MD
National Provider Identifier
1548113111
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DIVINE CHARIS HEALTH SERVICES LLC
Practice address
11005 Fillys Ford Xing
Upper Marlboro, MD 20772-8314
Phone
(202) 352-4059
NPI assigned
Feb 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Abong MiyehNPI 1770843385
Title
Owner
Phone
(202) 352-4059

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

11005 Fillys Ford Xing
Upper Marlboro, MD 20772-8314

Mailing address

11005 Fillys Ford Xing
Upper Marlboro, MD 20772-8314
Phone (202) 352-4059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260225003164 DC Part B Supplier - Clinic/Group Practice 0042791238 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

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": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1548113111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 FILLYS FORD XING",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728314",
            "telephone_number": "202-352-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11005 FILLYS FORD XING",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728314",
            "telephone_number": "202-352-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CHARIS HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "MIYEH",
        "authorized_official_first_name": "ABONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-352-4059"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.