Diversified Supportive Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

383203 Issued in PA

Legal business name

DIVERSIFIED SUPPORTIVE SERVICES

Practice address

2824 Cottman Ave
Suite 1
Philadelphia, PA 19149-1400

Phone

(215) 673-2778

Fax

(215) 673-3451

NPI assigned

Jun 17, 2008

Last updated

Jun 17, 2008By 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

Ms. Rasheen Halimah Beard

Title

Co-Manager

Phone

(215) 673-2778

Specialties & licenses 1

Addresses

Tax ID family

Diversified Supportive Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Diversified Supportive Services LLC

  • Home Health Agency
  • Phila, PA
  • NPI 1790807758
  NPD tax ID
• Diversified Supportive Services LLC

  • Case Management Agency
  • Philadelphia, PA
  • NPI 1922321173
  NPD tax ID

Locations

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1942461579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 COTTMAN AVE",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491400",
            "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": "2824 COTTMAN AVE",
            "address_2": "SUITE 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491400",
            "telephone_number": "215-673-2778",
            "fax_number": "215-673-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED SUPPORTIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "RASHEEN",
        "authorized_official_middle_name": "HALIMAH",
        "authorized_official_title_or_position": "CO-MANAGER",
        "authorized_official_telephone_number": "215-673-2778",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "PA",
            "license": "383203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shashi Raj Divaker, M.D.
• Alexandra Valentina Diventura, CRNP
• Diverse Body Sculpturing
• Diversified Home & Community Services LLC
• Diversified Psychological Resources, P.C.
• Diversified Supportive Services LLC
• Christie Lee Diveterano, CRNP
• Divine Breath Home Care Center
• Divine Comfort Home Health LLC
• Divine Connections Agency LLC

• Developmentally Disabled Services Day Training Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Developmentally Disabled Services Day Training Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.