Divine Heritage Services LLC

Primary specialty

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

Legal business name

DIVINE HERITAGE SERVICES LLC

Practice address

100 West Rd Ste 300
Towson, MD 21204-2370

Phone

(667) 304-0194

NPI assigned

Aug 21, 2024

Organization subpart

No

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

Authorized official

Name

Faith AregbesolaNPI 1487379251

Title

Owner

Phone

(667) 304-0194

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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

• Faith Olabisi Aregbesola, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1487379251
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1932932373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 WENNINGTON ST",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203150",
            "telephone_number": "667-304-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST RD STE 300",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042370",
            "telephone_number": "667-304-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HERITAGE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "AREGBESOLA",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "667-304-0194"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent A Dipietro, M.D.
• Joseph Donovan Dirocco, M.D.
• Deborah Disney, LCSW-C
• Ryan Daniel Distaso
• Jessica F Ditto, DNP, CPNP-PC, PMHS
• Dominic Dixon
• Jordan Dixon
• Mackenzie Dixon
• Meredith Alana Dixon, M.D.
• Rosalind Dizard

• Mental Health Clinic/Center (Including Community Mental Health Center) in Towson, MD
• Providers in Towson, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.