Active NPI
Diversified Supportive Services LLC
- Case Management Agency
- Philadelphia, PA
National Provider Identifier
1922321173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 383203
- Legal business name
- DIVERSIFIED SUPPORTIVE SERVICES LLC
- Practice address
- 1714 Memphis St
Suite C-8
Philadelphia, PA 19125-2700 - Phone
- (215) 673-2778
- Fax
- (215) 673-3451
- NPI assigned
- Mar 2, 2010
- Last updated
- Feb 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Rasheen Bethel
- Title
- Ceo
- Phone
- (215) 673-2778
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 383203 | PA | Primary |
| Home Health Agency | 251E00000X | 16723601 | PA |
Addresses
Primary practice location
1714 Memphis St
Suite C-8
Philadelphia, PA 19125-2700
Mailing address
1714 Memphis St
Suite C-8
Philadelphia, PA 19125-2700
Phone (215) 673-2778
National Provider Directory
National Provider Directory- Tax ID family
- Diversified Supportive Services LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- Philadelphia, PA
- NPI 1942461579
-
- Home Health Agency
- Phila, PA
- NPI 1790807758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267488000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1456272000000",
"number": "1922321173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1714 MEMPHIS ST",
"address_2": "SUITE C-8",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191252700",
"telephone_number": "215-673-2778",
"fax_number": "215-673-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1714 MEMPHIS ST",
"address_2": "SUITE C-8",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191252700",
"telephone_number": "215-673-2778",
"fax_number": "215-673-3451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIVERSIFIED SUPPORTIVE SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-02",
"last_updated": "2016-02-24",
"status": "A",
"authorized_official_last_name": "BETHEL",
"authorized_official_first_name": "RASHEEN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "215-673-2778",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "PA",
"license": "383203",
"primary": true
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "PA",
"license": "16723601",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
- Alexandra Valentina Diventura, CRNP
- Diverse Body Sculpturing
- Diversified Home & Community Services LLC
- Diversified Psychological Resources, P.C.
- Diversified Supportive Services
- Christie Lee Diveterano, CRNP
- Divine Breath Home Care Center
- Divine Comfort Home Health LLC
- Divine Connections Agency LLC
- Divine Connections Home Care Agency (None)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.