Divine Care 1962

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

121-01-459-1 Issued in GA

Legal business name

DIVINE CARE 1962

Practice address

1962 Neptune Dr
Augusta, GA 30906-5703

Phone

(706) 798-2289

Fax

(706) 792-6228

NPI assigned

Nov 11, 2010

Last updated

Nov 11, 2010By 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

Mr. Joseph Shanks

Title

Owner

Phone

(706) 798-2289

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1851692545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1962 NEPTUNE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065703",
            "telephone_number": "706-798-2289",
            "fax_number": "706-792-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 NEPTUNE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065703",
            "telephone_number": "706-798-2289",
            "fax_number": "706-792-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CARE 1962",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-798-2289",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "121-01-459-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Augusta, GA
• Providers in Augusta, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.