Divine Providence Homes LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DIVINE PROVIDENCE HOMES LLC

Practice address

1445 Winthrop St N
Saint Paul, MN 55119-3065

Phone

(651) 327-1445

Fax

(651) 327-1445

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Karen Borra Mendoza, RN

Title

Owner

Phone

(651) 785-6880

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1689246183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 WINTHROP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193065",
            "telephone_number": "651-327-1445",
            "fax_number": "651-327-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 WINTHROP ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551193065",
            "telephone_number": "651-327-1445",
            "fax_number": "651-327-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "BORRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-785-6880",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Dittmer Flemig, MD
• Diversity Home Health Care, Inc.
• Divine Health and Counseling Services
• Divine Health LLC
• Divine Healthcare Corporation
• Colby Adams Dixon, M.D.
• Kerry A Dixon, APRN, APNP, CNM
• Michael L. Dixon, DC
• Diy Intervention LLC
• Jlor Mesa Dizon, MD

• Assisted Living Facility in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.