Divine Leisure & Activity Center ,LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

DIVINE LEISURE & ACTIVITY CENTER ,LLC

Practice address

6500 W 4TH Ave Ste 26
Hialeah, FL 33012-6606

Phone

(786) 413-8657

NPI assigned

Nov 3, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Emilenes Dominguez

Title

Owner

Phone

(786) 413-8657

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1679174924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 W 7TH CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122518",
            "telephone_number": "786-413-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 W 4TH AVE STE 26",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126606",
            "telephone_number": "786-413-8657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE LEISURE & ACTIVITY CENTER ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "EMILENES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-413-8657",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9482",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Betty Dixon
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• DLC Rehab Services, Inc
• DLD Medical Center Inc

• Adult Day Care Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.