Divine Development Disability LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

DIVINE DEVELOPMENT DISABILITY LLC

Practice address

15 Clydesdale Rd
Scotch Plains, NJ 07076-2409

Phone

(732) 789-6683

NPI assigned

Apr 3, 2023

Organization subpart

No

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

Authorized official

Name

Rajasshri Phadnaik

Title

Member

Phone

(732) 789-6683

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1558066399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CLYDESDALE RD",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070762409",
            "telephone_number": "732-789-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CLYDESDALE RD",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070762409",
            "telephone_number": "732-789-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE DEVELOPMENT DISABILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A",
        "authorized_official_last_name": "PHADNAIK",
        "authorized_official_first_name": "RAJASSHRI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-789-6683"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Scotch Plains, NJ
• Providers in Scotch Plains, NJ by specialty
• Developmental Disabilities Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.