NPIMap

Organization Active NPI

Devine Care Consumer Direct Services,LLC

  • Adult Care Home Facility
  • Florissant, MO
National Provider Identifier
1861830093
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
842 Issued in MO
Legal business name
DEVINE CARE CONSUMER DIRECT SERVICES,LLC
Practice address
3236 Parker Rd
Florissant, MO 63033-3733
Phone
(314) 856-9393
Fax
(314) 856-9677
NPI assigned
Jun 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Authorized official

Name
Mrs. Folasade Ayinmodu
Title
Director
Phone
(314) 323-9426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 842 MO Primary

Addresses

Primary practice location

3236 Parker Rd
Florissant, MO 63033-3733

Mailing address

3236 Parker Rd
Florissant, MO 63033-3733
Phone (314) 856-9393

Other identifiers 1

IdentifierTypeStateIssuer
1801029673MedicaidMO

Other names 1

  • Classic adults day care center Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1861830093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 PARKER RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630333733",
            "telephone_number": "314-856-9393",
            "fax_number": "314-856-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 PARKER RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630333733",
            "telephone_number": "314-856-9393",
            "fax_number": "314-856-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVINE CARE CONSUMER DIRECT SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "AYINMODU",
        "authorized_official_first_name": "FOLASADE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-323-9426",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MO",
            "license": "842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801029673",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Classic adults day care center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.