Divine Intervention Recovery Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DIVINE INTERVENTION RECOVERY CENTER, LLC

Doing business as

Divine Intervention Recovery Center

Practice address

7373 Dayton Springfield Rd
Enon, OH 45323-1462

Phone

(937) 862-0008

NPI assigned

Jul 6, 2023

Last updated

Jul 6, 2023By 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

Fayetta Barron, LISW-S

Title

Director of Clinical Services

Phone

(937) 862-0008

Specialties & licenses 1

Addresses

Other names 1

• Divine Intervention Recovery Center Doing business as

Tax ID family

Divine Intervention Recovery Center 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 Intervention Recovery Center, LLC

  dba Divine Intervention Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Enon, OH
  • NPI 1093430126
  NPD tax ID

Locations

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1629756176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 DAYTON SPRINGFIELD RD",
            "city": "ENON",
            "state": "OH",
            "postal_code": "453231462",
            "telephone_number": "937-862-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 DAYTON SPRINGFIELD RD",
            "city": "ENON",
            "state": "OH",
            "postal_code": "453231462",
            "telephone_number": "937-862-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "BARRON",
        "authorized_official_first_name": "FAYETTA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "937-862-0008",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Intervention Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Bendall
• Julia Marie Brugler, RN
• Tara Marie Cooper
• Jessica Deese, CDCA
• Divine Intervention Recovery Center, LLC (Divine Intervention Recovery Center)
• Divine Intervention Recovery Center, LLC (Divine Intervention Recovery Center)
• Brenda Lee Driscoll
• Ernst F. Fischer O.D., Inc.
• Ferguson Chiropractic Solutions
• Ferguson Chiropractic Solutions LLC (Ohio Pain Solutions)

• Community/Behavioral Health Agency in Enon, OH
• Providers in Enon, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.