Divine Healthcare

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DIVINE HEALTHCARE

Practice address

1778 Grande View Ave
Severn, MD 21144-3333

Phone

(410) 551-5849

Fax

(410) 551-0685

NPI assigned

Nov 5, 2021

Last updated

Nov 5, 2021By 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

Abimbola Hillard, PMHNPNPI 1487112983

Title

President

Phone

(410) 551-5849

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abimbola Hillard, FNP-BC, PMHNP

  • Family Nurse Practitioner
  • Severn, MD
  • NPI 1487112983
  Authorized official Same address or phone

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1780349639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 GRANDE VIEW AVE",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211443333",
            "telephone_number": "410-551-5849",
            "fax_number": "410-551-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1778 GRANDE VIEW AVE",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211443333",
            "telephone_number": "410-551-5849",
            "fax_number": "410-551-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "HILLARD",
        "authorized_official_first_name": "ABIMBOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-551-5849",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brice Diagong
• Augustus Dickens
• Kassandra A Dickens, CRNP
• Oluchi Dike, M.D.
• Divine Healthcare
• Divine Solutions
• Prajakta Dravid
• Shannon Leigh Drechsler
• Emade Ebah Edongole
• Beverly Ebanks

• Mental Health Clinic/Center (Including Community Mental Health Center) in Severn, MD
• Providers in Severn, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.