NPIMap

Organization Active NPI

DHC Divine Health Care, LLC

  • Home Health Agency
  • McAllen, TX
National Provider Identifier
1952602849
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
013812 Issued in TX
Legal business name
DHC DIVINE HEALTH CARE, LLC
Practice address
4309 North 10TH Street
Ste. C
McAllen, TX 78504
Phone
(956) 563-7509
Fax
(956) 687-7509
NPI assigned
Nov 8, 2010
Last updated
Feb 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Mrs. Lisa Ann Blum, RNNPI 1053047209
Title
Administrator
Phone
(956) 563-7509

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 013812 TX Primary
Attendant Care Provider 3747A0650X
Personal Care Attendant 3747P1801X
Prevention Professional 405300000X

Addresses

Primary practice location

4309 North 10TH Street
Ste. C
McAllen, TX 78504

Mailing address

4309 North 10TH Street
Ste. C
McAllen, TX 78504
Phone (956) 563-7509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120118000738 TX Part A Provider - Home Health Agency 4880861640 Practice locations: McAllen, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952602849. Details of each certification follow.

Home health agency certification: CCN 747735

Legal name
DHC DIVINE HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 8, 2012
Last certification
Mar 4, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 7, 2010 in TX
Enrollment address
4309 N 10TH Street
Suite C
McAllen, TX 78504-3085

Care Compare: Home health agency

Medicare Care Compare
Listed as
DHC Divine Health Care LLCCCN 747735 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jun 8, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
DHC Divine Health Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4311 N 10th St
Ste B1
McAllen, TX 78504
Phone (956) 563-7509

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jamie Solis Individual 5% Or Greater Direct Ownership Interest Aug 2, 2013 33.3%
5% Or Greater Indirect Ownership Interest Nov 7, 2010
General Partnership Interest Aug 2, 2013 33.3%
Corporate Officer Aug 2, 2013 33.3%
Corporate Director Aug 2, 2013 33.3%
W-2 Managing Employee Aug 2, 2013 33.3%
Operational/Managerial Control Aug 2, 2013 33.3%
Mary Garcia Individual 5% Or Greater Direct Ownership Interest Aug 2, 2013 33.4%
5% Or Greater Indirect Ownership Interest Nov 7, 2010
General Partnership Interest Aug 2, 2013 33.4%
Corporate Officer Aug 2, 2013 33.4%
Corporate Director Aug 2, 2013 33.4%
W-2 Managing Employee Aug 2, 2013 33.4%
Operational/Managerial Control Aug 2, 2013 33.4%
Lisa Blum Individual 5% Or Greater Direct Ownership Interest Aug 2, 2013 33.3%
5% Or Greater Indirect Ownership Interest Nov 7, 2010
General Partnership Interest Aug 2, 2013 33.3%
Corporate Officer Aug 2, 2013 33.3%
Corporate Director Aug 2, 2013 33.3%
W-2 Managing Employee Aug 2, 2013 33.3%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Lisa Ann Blum
    • Nurse Practitioner
    • McAllen, TX
    • NPI 1053047209

    5% Or Greater Direct Ownership Interest, 5% Or Greater Indirect Ownership Interest, Corporate Director, Corporate Officer, General Partnership Interest, W-2 Managing Employee

    CMS ownership

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.

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1952602849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 NORTH 10TH STREET",
            "address_2": "STE. C",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "78504",
            "telephone_number": "956-563-7509",
            "fax_number": "956-687-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 NORTH 10TH STREET",
            "address_2": "STE. C",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "78504",
            "telephone_number": "956-563-7509",
            "fax_number": "956-687-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHC DIVINE HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "956-563-7509",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "013812",
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.