Divine Recovery Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DIVINE RECOVERY SERVICES LLC

Practice address

2775 Clifton Ave
Creedmoor, NC 27522-9511

Phone

(919) 529-0325

NPI assigned

Jun 24, 2019

Last updated

Jul 9, 2019By 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

Sheila Jean Burge

Title

Ceo

Phone

(919) 529-0325

Specialties & licenses 6

Addresses

Tax ID family

Divine Recovery Services 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 Recovery Services, LLC

  • Community/Behavioral Health Agency
  • Creedmoor, NC
  • NPI 1780236497
  NPD tax ID

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1770144420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 CLIFTON AVE",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275229511",
            "telephone_number": "919-529-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 CLIFTON AVE",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275229511",
            "telephone_number": "919-529-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "BURGE",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-529-0325"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn B Daniels
• Jessica Day
• Sonia De la Cruz
• Elvie Mercullo Dee, PT, DPT
• Dillard Counseling & Consultation Services, PLLC
• Divine Recovery Services, LLC
• Carin Louise Donnell, SLP-A
• Dr. Robert M Currin OD,PA
• Duke University Affiliated Physicians, Inc. (Duke Primary Care Butner-Creedmor)
• Charles J Durham

• Community/Behavioral Health Agency in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.