Divine Intervention Recovery Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DIVINE INTERVENTION RECOVERY CENTER, LLC

Doing business as

Divine Intervention Recovery Center

Practice address

7373 Dayton Springfield Rd
Enon, OH 45323-1462

Phone

(937) 862-0008

Fax

(937) 340-7004

NPI assigned

Apr 6, 2022

Last updated

Oct 10, 2022By 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

Fayetta J Barron, LISWSNPI 1487196788

Title

Owner

Phone

(937) 241-9230

Specialties & licenses 3

Addresses

Other names 1

• Divine Intervention Recovery Center Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fayetta Barron, LISW-S, LICDC

  • Social Worker
  • Fairborn, OH
  • NPI 1487196788
  Authorized official Same address or phone

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1912648528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 DAYTON SPRINGFIELD RD",
            "city": "ENON",
            "state": "OH",
            "postal_code": "453231462",
            "telephone_number": "937-862-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 DAYTON SPRINGFIELD RD",
            "city": "ENON",
            "state": "OH",
            "postal_code": "453231462",
            "telephone_number": "937-862-0008",
            "fax_number": "937-340-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-10-10",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "BARRON",
        "authorized_official_first_name": "FAYETTA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-241-9230",
        "authorized_official_credential": "LISWS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "faye.barron@counselingsecure.com",
            "affiliation": "N",
            "endpointDescription": "Secure Hipaa compliant email",
            "address_1": "7373 Dayton Springfield Rd",
            "city": "Enon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453231462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Divine Intervention Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Divine Intervention Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Marie Brugler, RN
• Tara Marie Cooper
• Jessica Deese, CDCA
• Divine Intervention Recovery Center, LLC (Divine Intervention Recovery Center)
• Divine Intervention Recovery Center, LLC (Divine Intervention Recovery Center)
• Brenda Lee Driscoll
• Ernst F. Fischer O.D., Inc.
• Ferguson Chiropractic Solutions
• Ferguson Chiropractic Solutions LLC (Ohio Pain Solutions)
• Keturah Fulton

• Mental Health Clinic/Center (Including Community Mental Health Center) in Enon, OH
• Providers in Enon, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.