DIVINITY COMMUNITY LIVING, INC. (NPI# 1295394377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295394377 |
| Entity Type | Organization |
| Organization Name | DIVINITY COMMUNITY LIVING, INC. |
| Other Organization Name | DCL |
| Practice Address |
405 Briarwood Dr Ste 108q Jackson MS 39206-3032 |
| Practice Telephone | 7695727327 |
| Mailing Telephone | 7695727327 |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | SUSAN Y WILLIAMS (CEO) |
| Authorized Official Telephone | 6014624513 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| Other Name | Type Code |
|---|---|
| DCL | Other Name - Individual/Organization |
| Divinity Community Living, LLC | Doing Business As Name - Organization |
| Street Address |
405 BRIARWOOD DR STE 108Q |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-3032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407067 | Mjp Management LLC | In Home Supportive Care | 1 Comtronics Pl, Jackson, MI 49203-7500 | 2020-11-05 |
| 1639776750 | Hope Supportive LLC. | In Home Supportive Care | 6295 Old Canton Rd Apt 19d, Jackson, MS 39211-2934 | 2020-10-01 |
| 1548890858 | Davis Healthcare Facility | In Home Supportive Care | 419 S State St Ste B100-4, Jackson, MS 39201-5005 | 2020-01-26 |
| 1104456979 | Carefree Living At Home LLC | In Home Supportive Care | 460 Briarwood Dr Ste 400-1010, Jackson, MS 39206-3051 | 2020-01-21 |
| 1164088415 | Canaan Homehealth Care | In Home Supportive Care | 17 Danielle Ct, Jackson, NJ 08527-2929 | 2019-05-13 |
| 1356801393 | Victor M Pickett | In Home Supportive Care | 227 Kilmaine Ct, Jackson, MS 39209-3651 | 2019-03-25 |
| 1902360571 | Resilience Home Care Services LLC | In Home Supportive Care | 5135 Galaxie Dr Ste E, Jackson, MS 39206-4300 | 2019-01-28 |
| 1689151789 | Sanedra Pegues | In Home Supportive Care | 4754 Dubarry Ln, Jackson, MS 39209-4929 | 2018-07-23 |
| 1548768708 | Shore Homecare Services LLC | In Home Supportive Care | 25 N County Line Rd Ste 18, Jackson, NJ 08527-1270 | 2018-01-23 |
| 1487161519 | The Journey of Knowledge | In Home Supportive Care | 2460 Terry Rd Ste 400, Jackson, MS 39204-5777 | 2018-01-10 |
| Find all providers in JACKSON | ||||
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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.