DIVINE HOUSE, LLC


Address: 3429 Stirrup Way, Virginia Beach, VA 23453-8546
Phone: 7572020825

DIVINE HOUSE, LLC (NPI# 1124262712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124262712
Entity Type Organization
Organization Name DIVINE HOUSE, LLC
Practice Address 3429 Stirrup Way
Virginia Beach
VA 23453-8546
Mailing Address 912 Beaumeade Ct
Virginia Beach
VA 23462-4642
Practice Telephone 7572020825
Mailing Telephone 7572020825
Enumeration Date 2009-04-27
Last Update Date 2009-04-27
Authorized Official Name BELA SV AMIN (ADMINISTRATOR)
Authorized Official Telephone 7572020825
Authorized Official Credential PT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1157 VA Residential Treatment Facilities

Office Location

Street Address 3429 STIRRUP WAY
City VIRGINIA BEACH
State VA
Zip Code 23453-8546

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1811359623 Jana Leigh Dillon Behavioral Analyst 3101 Magic Hollow Blvd Ste 101, Virginia Beach, VA 23453 2016-03-22
1679903249 Carmen Robinson Physical Therapy Assistant 3729 Purebred Dr, Virginia Beach, VA 23453 2013-11-19
1386986891 Christina Pryor Behavioral Analyst Nbc 1531 Amberley Forest Road, Virginia Beach, VA 23453 2013-03-22
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1730405879 Coastal Dermatology P.C. Dermatology 3176 Holland Rd., 103, Virginia Beach, VA 23453 2010-04-14
1235466277 Michael Allen Brasko Specialist/Technologist, Other 2604 Olympic Drive, Virginia Beach, VA 23453 2009-11-12
1518101385 Matthew Faauli Social Worker 3134 Magic Hollow Blvd, Ste 200, Virginia Beach, VA 23453 2009-04-23
1104902246 Cynthia Tapp Elswick Social Worker 3432 Magic Hollow Blvd, Suite 200, Va. Beach, VA 23453 2006-10-31
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Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1881255701 Omega Group, LLC. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1075 Glen Willow Dr, Virginia Beach, VA 23462-5216 2019-06-21
1851866479 Amethyst Care Group Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 6253 Auburn Dr, Virginia Beach, VA 23464-3714 2018-10-10
1013452317 Genuine Hearts Community Care LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4824 Cliffony Dr, Virginia Beach, VA 23464-8401 2016-12-22
1093866691 Faith Hope & Charity Residential Care Center LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3409 Dana Lane, Virginia Beach, VA 23452 2007-01-12
1205858461 Alpha Community Services Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 717 Independence Blvd, Suite 209, Virginia Beach, VA 23451-0532 2006-07-24
1598308116 Madge Barnes Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4713 Thresher Ct, Virginia Beach, VA 23464-6310 2019-10-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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1568069987 New Development Services LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4610 Milfax Rd, North Chesterfield, VA 23224-5604 2020-10-08
1114524766 Latoya Steward Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 805 Admiral Gravely Blvd, Richmond, VA 23231 2020-10-07
1780281808 Romco Enterprises, Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3409 Scott St, Portsmouth, VA 23707-4001 2020-10-01
1710596051 Dare To Dream Family Services, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2905 Steed Ct, Chesapeake, VA 23323-2843 2020-07-22
1366064313 Monica Lotoria Ballou Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1345 N Main St, Danville, VA 24540-3721 2020-05-13
1790306934 Serenity Residential Servicess, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 6225 Wilmington Dr, Burke, VA 22015-3828 2020-04-28
1407483316 Lighthouse Residential Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 5219 Summerleaf Dr, North Chesterfield, VA 23234-2817 2020-03-23
1457983538 Rokel Health Care Services LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 7905 Dassett Ct Apt 304, Annandale, VA 22003-4878 2020-02-06
1790316388 Precious Healthcare LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 6732 Harrison Ln, Alexandria, VA 22306-1526 2020-02-01
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Competitor

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City VIRGINIA BEACH
Zip Code 23453

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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