Organization Active NPI

Divine Hands of Care, Inc

  • Community/Behavioral Health Agency
  • Fort Pierce, FL
National Provider Identifier
1700066073
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
688140896 Issued in FL
Legal business name
DIVINE HANDS OF CARE, INC
Practice address
4140 Worlington Ter
Fort Pierce, FL 34947-1335
Phone
(772) 528-6628
Fax
(772) 466-4988
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Mr. Dan Edward Darrisaw II
Title
Ceo
Phone
(772) 528-6628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 688140896 FL Primary

Addresses

Primary practice location

4140 Worlington Ter
Fort Pierce, FL 34947-1335

Mailing address

4140 Worlington Ter
Fort Pierce, FL 34947-1335
Phone (772) 528-6628

Other identifiers 2

IdentifierTypeStateIssuer
688140898MedicaidFL
688140896MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1700066073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 WORLINGTON TER",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471335",
            "telephone_number": "772-528-6628",
            "fax_number": "772-466-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 WORLINGTON TER",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349471335",
            "telephone_number": "772-528-6628",
            "fax_number": "772-466-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HANDS OF CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "DARRISAW",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-528-6628",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "688140896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688140898",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688140896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.