Divine Star HHC LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE STAR HHC LLC

Practice address

15101 E Iliff Ave Ste 206
Aurora, CO 80014-4543

Phone

(720) 317-3589

NPI assigned

Aug 25, 2020

Organization subpart

No

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

Authorized official

Name

Laura Badasyan

Title

Owner

Phone

(720) 317-3589

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Home health agency certification: CCN 067623

Legal name

DIVINE STAR HHC LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 17, 2022

Last certification

Oct 6, 2022

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 15, 2020 in CO

Enrollment address

15101 E Iliff Ave
Ste 206
Aurora, CO 80014-4543

Listed as

Divine Star HHC LLCCCN 067623

Ownership

Proprietary

Certified

Oct 17, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

Divine Star HHC LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Divine Star HHC LLC

  • Personal Care Attendant
  • Aurora, CO
  • NPI 1114885068
  NPD tax ID
• Divine Star HHC LLC

  • In Home Supportive Care Agency
  • Aurora, CO
  • NPI 1780552174
  NPD tax ID

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Divine Star HHC LLC

  • Personal Care Attendant
  • Aurora, CO
  • NPI 1114885068
  NPPES parent name
• Divine Star HHC LLC

  • In Home Supportive Care Agency
  • Aurora, CO
  • NPI 1780552174
  NPPES parent name

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1760095285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21030 E ELDORADO DR",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800138483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15101 E ILIFF AVE STE 206",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800144543",
            "telephone_number": "720-317-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE STAR HHC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "BADASYAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-317-3589"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Interventions, LLC
• Divine Royal Care, LLC
• Divine Royal Care, LLC
• Divine Son LLC
• Divine Star HHC LLC
• Divine Star HHC LLC
• Matison Divita, OT
• Krista J Divittore, PSYD
• Mithun Diwakar, M.D., PH.D.
• Corinne R Dix, MD

• Home Health Agency in Aurora, CO
• Providers in Aurora, CO by specialty
• Home Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.