Divine Treatment Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DIVINE TREATMENT CENTER LLC

Practice address

3707 E Southern Ave Ste 2079
Mesa, AZ 85206-6219

Phone

(602) 394-5989

NPI assigned

Jul 7, 2023

Last updated

Jul 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

C&A HOMECARE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Carnot Munyandamutsa

Title

Administrator

Phone

(602) 394-5989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1609554989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE STE 2079",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066219",
            "telephone_number": "602-394-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE STE 2079",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066219",
            "telephone_number": "602-394-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE TREATMENT CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "C&A HOMECARE LLC",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "MUNYANDAMUTSA",
        "authorized_official_first_name": "CARNOT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-394-5989",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bridget Dixon
• Jessica Dixon, FNP
• Kimberley Dixon, LPC
• Zachary Dixson, LPC

• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.