Divine Living Limited Liability Company

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DIVINE LIVING LIMITED LIABILITY COMPANY

Practice address

202 E Lanvale St
Baltimore, MD 21202-2814

Phone

(443) 682-3762

NPI assigned

Dec 14, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Victor Egbiremolen

Title

Owner/Assisted Living Manager

Phone

(443) 682-3762

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1871189985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8620 PLEASANT PLAINS RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212862351",
            "telephone_number": "443-682-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E LANVALE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022814",
            "telephone_number": "443-682-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE LIVING LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "EGBIREMOLEN",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER/ASSISTED LIVING MANAGER",
        "authorized_official_telephone_number": "443-682-3762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Health Systems, Inc
• Divine Light
• Divine Light Residential Treatment LLC
• Divine Light Residential Treatment LLC
• Divine Light Residential Treatment LLC
• Divine Mercy, Inc.
• Divine Mercy, Inc.
• Divine Mercy, Inc.
• Divine Mercy, Inc.
• Divine Mercy, Inc.

• Assisted Living Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.