Organization Active NPI

Divine Community Care (ABA Therapy), Inc.

  • Behavior Analyst
  • Northborough, MA
National Provider Identifier
1922757962
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DIVINE COMMUNITY CARE (ABA THERAPY), INC.
Practice address
300 W Main St Ste 104
Northborough, MA 01532-2132
Phone
(508) 375-8333
NPI assigned
Mar 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Sulaiman Abass Kamara
Title
Owner
Phone
(508) 375-8333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

300 W Main St Ste 104
Northborough, MA 01532-2132

Mailing address

300 W Main St Ste 104
Northborough, MA 01532-2132
Phone (508) 375-8333

Other identifiers 1

IdentifierTypeStateIssuer
001543112OtherMASECRETARY OF STATE

National Provider Directory

National Provider Directory

Locations

300 W Main St
Ste 104
Northborough, MA 01532
Phone (508) 375-8333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1922757962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST STE 104",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322132",
            "telephone_number": "508-375-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MAIN ST STE 104",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322132",
            "telephone_number": "508-375-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE COMMUNITY CARE (ABA THERAPY), INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "KAMARA",
        "authorized_official_first_name": "SULAIMAN",
        "authorized_official_middle_name": "ABASS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-375-8333"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECRETARY OF STATE",
            "identifier": "001543112",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.