DIVINE SUPPORTS & HOMES INC. (NPI# 1114400157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114400157 |
Entity Type | Organization |
Organization Name | DIVINE SUPPORTS & HOMES INC. |
Practice Address |
13005 Maepine Ct Fairfax VA 22033-3130 |
Mailing Address |
9716 Anita Ln Lanham MD 20706-3307 |
Practice Telephone | 2404137682 |
Mailing Telephone | 2404137682 |
Enumeration Date | 2018-09-14 |
Last Update Date | 2018-09-14 |
Authorized Official Name | MRS. MAVIS NGUM TAH (CEO) |
Authorized Official Telephone | 2404137682 |
Authorized Official Credential | RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
Virginia Business Entities | Divine Supports & Homes Inc. | 6104 Virgo Ct, Burke, Virginia 22015-3249 |
Street Address |
13005 MAEPINE CT |
City | FAIRFAX |
State | VA |
Zip Code | 22033-3130 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
Find all providers in zip 22033 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770196339 | Jilly Healthcare Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4145 Lenox Dr, Fairfax, VA 22032-1112 | 2020-08-24 |
1790317105 | Zrahil Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10905 Fairchester Dr, Fairfax, VA 22030-4807 | 2020-02-04 |
1790321800 | Community Comfort Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Richard Ave, Fairfax, VA 22031-3535 | 2019-11-24 |
1609410273 | Hands of Mercy Group Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12783 Cruz Ct, Fairfax, VA 22030-7283 | 2019-11-06 |
1568965333 | William Henry Barnes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3112 Plantation Pkwy, Fairfax, VA 22030-2118 | 2018-03-17 |
1427400050 | Compassionate Care Group Homes, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4413 San Carlos Dr, Fairfax, VA 22030-5372 | 2016-07-07 |
1922191121 | Community Living Alternatives, Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9401 Lee Hwy, Suite 406, Fairfax, VA 22031-1849 | 2006-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134729213 | Saint Claire Healthcare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5601 Seminary Rd Apt 915n, Falls Church, VA 22041-2997 | 2020-10-28 |
1780283275 | Great Day Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6606 Gills Gate Pl, Chesterfield, VA 23832-6004 | 2020-10-26 |
1306451448 | Nikita S Banks | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 505 Cumberland Street Ave, Ste 2, Portsmouth, VA 23704-2370 | 2020-09-15 |
1396359576 | Best Hope Community Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9662 Hawkshead Dr, Lorton, VA 22079-2786 | 2020-09-03 |
1609489038 | Viana Healthcare Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8205 Mockingbird Dr, Annandale, VA 22003-3713 | 2020-08-25 |
1225640279 | Guardian Angels Homecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1116 Pin Oak Drive, Suffolk, VA 23434-2343 | 2020-08-20 |
1659993079 | Collaborative Community LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6000 Filbert Ct, Springfield, VA 22152-1609 | 2020-05-07 |
1356962252 | Intellectual Services Group, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4813 Integrity Ct, Fredericksburg, VA 22408-1891 | 2020-05-01 |
1699394346 | Peace of Mind Residential Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Pinehurst Ln, Stafford, VA 22554-7288 | 2020-04-13 |
1487282729 | Eye Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 721 Cabin Creek Dr, Hopewell, VA 23860-5350 | 2020-03-31 |
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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.