Divine Group Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DIVINE GROUP HOME LLC

Practice address

40352 W Molly LN # a
Maricopa, AZ 85138-5158

Phone

(480) 939-0573

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Divine Kusi

Title

Admin

Phone

(480) 939-0573

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1972266955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40352 W MOLLY LN",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385158",
            "telephone_number": "480-939-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40352 W MOLLY LN # A",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385158",
            "telephone_number": "480-939-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "KUSI",
        "authorized_official_first_name": "DIVINE",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "480-939-0573"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele E. Dickinson, BSN RN
• Joseph O Diduro, DC DABCN MS
• Cherilin Michelle Diefenbacher-Phariss, LCSW
• Dignity Behavioral Health
• Direct Billing Animation LLC
• Jiaxi Dong, DO
• Kristina Donnay, FNP-C
• John A Donohue, D.C.
• Doug S Clouse MD PLC
• Tiffani Diane Douglas Miksch, RN

• Community/Behavioral Health Agency in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.