EMPOWERMENT OF DIVINE PROVIDENCE, INC. (NPI# 1295017382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295017382 |
| Entity Type | Organization |
| Organization Name | EMPOWERMENT OF DIVINE PROVIDENCE, INC. |
| Practice Address |
3 Birchfield Way Dallas GA 30132-0842 |
| Practice Telephone | 4042858415 |
| Mailing Telephone | 4042858415 |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2014-10-31 |
| Authorized Official Name | CLORISSAL LIU (OWNER) |
| Authorized Official Telephone | 4042858415 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | GA | Residential Treatment Facilities | |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | CN0030003852 | GA | Residential Treatment Facilities |
| Street Address |
3 BIRCHFIELD WAY |
| City | DALLAS |
| State | GA |
| Zip Code | 30132-0842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205398526 | Away Lice Removal Specialists, LLC | Homeopath | 531 Hardee Street, Dallas, GA 30132 | 2019-04-04 |
| 1306313184 | Jessica Ramskogler | Counselor | 168 N. Johnson St, Suite 304, Dallas, GA 30132 | 2018-10-30 |
| 1912489337 | Michelle Jennifer Bergman | Lactation Consultant, Non-RN | 549 Waburn Walk, Dallas, GA 30132 | 2018-09-01 |
| 1457870099 | Dynamic Xray Solutions LLC | Clinic/Center | 77 Wellsey Way, Dallas, GA 30132 | 2017-09-14 |
| 1528438413 | Georgia Dental Professionals, PC | Dentist | 8709 Dallas Acworth Hwy, Dallas, GA 30132 | 2015-10-05 |
| 1013256130 | Paulding Auto Sales | Private Vehicle | 210 E Memorial Dr, Dallas, GA 30132 | 2013-02-08 |
| 1255613410 | Matthew Lerandal Talley | Chiropractor | 1305 Cedarcrest Road Suite#111, Dallas, GA 30132 | 2011-09-14 |
| 1003109422 | Ashlyn Drugs | Pharmacy | 1160 Old Harris Rd, Dallas, GA 30132 | 2011-05-18 |
| 1285942086 | Premier Hearing and Health Services Inc | Clinic/Center | 300 W I Parkway Ste 207, Premier Hearing and Health Services Inc, Dallas, GA 30132 | 2010-09-15 |
| 1578878963 | Karen Parris | Speech-Language Pathologist | 283 Red Hawk Way, Dallas, GA 30132 | 2010-08-10 |
| Find all providers in zip 30132 | ||||
| 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 |
|---|---|---|---|---|
| 1770107831 | American Roses Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6330 S Lancaster Rd, Dallas, TX 75241-3800 | 2020-06-04 |
| 1841839727 | Bellview Advocacy Project LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14606 Dallas Pkwy Apt 1111, Dallas, TX 75254-7451 | 2019-12-25 |
| 1740832021 | Brittany Dory | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8004 W Virginia Dr Apt 908, Dallas, TX 75237-4425 | 2019-07-16 |
| 1235621368 | Infinite Hope Hcs, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4650 S Hampton Rd Ste 11, Dallas, TX 75232-1066 | 2018-06-04 |
| 1295246916 | Camilla Medina | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 Amos St, Dallas, TX 75212-5202 | 2017-10-20 |
| 1619351665 | Kimberly Hutchings | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9670 Forest Ln Apt 1109, Dallas, TX 75243-8639 | 2015-07-18 |
| 1346620259 | Sherry Clark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7030 Capella Park Ave, Dallas, TX 75236-3003 | 2015-06-05 |
| 1710377726 | U-niq Identity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 917 Fordham Rd, Dallas, TX 75216-6133 | 2015-01-28 |
| 1356747554 | A Su Lado Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Main St Apt 202, Dallas, TX 75202-4300 | 2014-11-15 |
| 1477957405 | Amethyst Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5863 Foxglove Ln, Dallas, TX 75249-1625 | 2014-10-20 |
| Find all providers in DALLAS | ||||
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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.