Divine Senior Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HCO-1790 Issued in VA

Legal business name

DIVINE SENIOR HOME CARE LLC

Practice address

17300 River Ridge Blvd Ste 202a
Woodbridge, VA 22191-5168

Phone

(703) 677-0506

NPI assigned

Jan 5, 2018

Last updated

Jan 5, 2018By 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

Bushra Chaudhary

Title

Administrator

Phone

(703) 677-0506

Specialties & licenses 1

Addresses

Other names 1

• Divine Senior Home Care LLC Former legal business name

Locations

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1841707213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 RIVER RIDGE BLVD STE 202A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915168",
            "telephone_number": "703-677-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 RIVER RIDGE BLVD STE 202A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915168",
            "telephone_number": "703-677-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SENIOR HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "CHAUDHARY",
        "authorized_official_first_name": "BUSHRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-677-0506"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO-1790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Senior Home Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.