NPIMap

Organization Active NPI

Divine Healthcare Services LLC

  • Home Health Agency
  • Clarksburg, MD
National Provider Identifier
1861019184
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIVINE HEALTHCARE SERVICES LLC
Practice address
22430 Glenbow Way
Clarksburg, MD 20871-9482
Phone
(301) 916-6276
NPI assigned
Jul 2, 2020
Last updated
Jul 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Authorized official

Name
Henrietta Henrietta
Title
Owner/Administrator
Phone
(301) 916-6276

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

22430 Glenbow Way
Clarksburg, MD 20871-9482

Mailing address

22430 Glenbow Way
Clarksburg, MD 20871-9482
Phone (301) 916-6276

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1861019184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22430 GLENBOW WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208719482",
            "telephone_number": "301-916-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22430 GLENBOW WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208719482",
            "telephone_number": "301-916-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "HENRIETTA",
        "authorized_official_first_name": "HENRIETTA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "301-916-6276"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.