Peter-Elst LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PETER-ELST LLC

Doing business as

Divine SupportbEdge Healthcare Services.

Practice address

3700 Lyckan Pkwy Ste a
Durham, NC 27707-2587

Phone

(919) 401-6655

NPI assigned

Dec 3, 2014

Organization subpart

No

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

Authorized official

Name

Olayide Olaniyan

Title

Ceo

Phone

(919) 401-6655

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Divine SupportbEdge Healthcare Services. Doing business as

Tax ID family

Divine Supportbedge Healthcare Services2 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.

• Peter-Elst LLC

  • In Home Supportive Care Agency
  • Durham, NC
  • NPI 1780917294
  NPD tax ID

Locations

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1962809152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 LYCKAN PKWY",
            "address_2": "SUITE A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072577",
            "telephone_number": "919-401-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 LYCKAN PKWY STE A",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072587",
            "telephone_number": "919-401-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER-ELST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "OLANIYAN",
        "authorized_official_first_name": "OLAYIDE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-401-6655"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418993",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine SupportbEdge Healthcare Services.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Michael Peseski, D.O.
• Peter a Tzendzalian, DDS, PA
• Peter F. Adland, M.D., P.a.
• Peter Perlman
• Peter-Elst LLC
• Andrew Peter, MD
• Elaine Longoria Peter
• Samuel Cody Peter, PHD
• Ann Peterkin, PHARMD
• Ashley Peters

• Community/Behavioral Health Agency in Durham, NC
• Providers in Durham, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.