NPIMap

Organization Active NPI

Divine Care Health and Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
National Provider Identifier
1932861614
Registry record updated Oct 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DIVINE CARE HEALTH AND WELLNESS LLC
Practice address
500 Westgate Dr # 1016
Brockton, MA 02301-1855
Phone
(857) 574-4497
NPI assigned
Oct 9, 2021
Last updated
Oct 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2021

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

Authorized official

Name
Elsie AdibeNPI 1962960930
Title
Psychiatric Mental Health Nurse Pra
Phone
(857) 574-4497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

500 Westgate Dr # 1016
Brockton, MA 02301-1855

Mailing address

500 Westgate Dr # 1016
Brockton, MA 02301-1855
Phone (857) 574-4497

National Provider Directory

National Provider Directory

Locations

500 Westgate Dr
#1016
Brockton, MA 02301
Phone (857) 574-4497

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1633737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633737600000",
    "number": "1932861614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1016",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "857-574-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTGATE DR # 1016",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011855",
            "telephone_number": "857-574-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CARE HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-09",
        "last_updated": "2021-10-09",
        "certification_date": "2021-10-09",
        "status": "A",
        "authorized_official_last_name": "ADIBE",
        "authorized_official_first_name": "ELSIE",
        "authorized_official_title_or_position": "PSYCHIATRIC MENTAL HEALTH NURSE PRA",
        "authorized_official_telephone_number": "857-574-4497"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2021; 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.