Divine Royal Care, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

14689740 Issued in CO

Legal business name

DIVINE ROYAL CARE, LLC

Practice address

10730 E Bethany Dr Ste 185
Aurora, CO 80014-2690

Phone

(303) 695-6684

Fax

(303) 856-3389

NPI assigned

Apr 3, 2016

Last updated

Apr 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Victor O. Wagidi

Title

Executive Director

Phone

(303) 695-6684

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Divine Royal Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Divine Royal Care, LLC

  • Non-emergency Medical Transport (VAN)
  • Aurora, CO
  • NPI 1235505132
  NPD tax ID

Locations

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459641600000",
    "number": "1619330974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10730 E BETHANY DR STE 185",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142690",
            "telephone_number": "303-695-6684",
            "fax_number": "303-856-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 E BETHANY DR STE 185",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142690",
            "telephone_number": "303-695-6684",
            "fax_number": "303-856-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE ROYAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-03",
        "last_updated": "2016-04-03",
        "status": "A",
        "authorized_official_last_name": "WAGIDI",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-695-6684",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CO",
            "license": "14689740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14689740",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Dedication Inc
• Divine Forever Care LLC
• Divine Health & Wellness, LLC
• Divine Interventions, LLC (Divine Interventions Agency)
• Divine Royal Care, LLC
• Divine Son LLC
• Divine Star HHC LLC
• Divine Star HHC LLC
• Divine Star HHC LLC
• Annabelle Divita

• In Home Supportive Care Agency in Aurora, CO
• Providers in Aurora, CO by specialty
• In Home Supportive Care Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2016; 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.