DIVINE AT HILLSBORO ST INC. (NPI# 1871000141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871000141 |
| Entity Type | Organization |
| Organization Name | DIVINE AT HILLSBORO ST INC. |
| Practice Address |
502 N Hillsboro St Youngsville NC 27596-7779 |
| Practice Telephone | 9198804619 |
| Mailing Telephone | 9198804619 |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |
| Authorized Official Name | CHRIS O ISIJOLA (OWNER/PRESIDENT) |
| Authorized Official Telephone | 9198804619 |
| Authorized Official Credential | ADMINISTRATOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Divine At Hillsboro St Inc | 502 N Hillboro St, Youngsville, NC 27596 |
| Street Address |
502 N HILLSBORO ST |
| City | YOUNGSVILLE |
| State | NC |
| Zip Code | 27596-7779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879313 | Harp Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 12339 Wake Union Church Rd Ste 108, Wake Forest, NC 27596 | 2019-09-10 |
| 1326560806 | Nirali Patel | Pharmacist | 1190 Us Hwy 1n, Youngsville, NC 27596 | 2017-07-17 |
| 1790109577 | Riphen Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Blue Heron Drive, Youngsville, NC 27596 | 2014-02-13 |
| 1831524768 | Janice D Clark, Dds, Pa | Dentist | 680 Us Hwy 1 N, Suite 500, Youngsville, NC 27596 | 2013-09-11 |
| 1720372733 | Sherri Culbertson | Pharmacist | 1190 Us Hwy 1 North, Youngsville, NC 27596 | 2011-06-07 |
| 1326368390 | Trg Health Care Systems LLC | Social Worker | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2010-06-01 |
| 1932250065 | Catherine Grace Busam | Counselor | 90 Wheaton Dr, Youngsville, NC 27596 | 2007-01-16 |
| 1316022700 | Emmett Smoak Ackermon Jr. | Dentist | 66 Wheaton Ave, Youngsville, NC 27596 | 2006-10-26 |
| 1750323960 | Matthew Mullen | Specialist | 700 Us 1 Hwy Ste 100, Youngsville, NC 27596 | 2006-06-12 |
| 1992074314 | Trg Health Care Systems LLC | Community/Behavioral Health | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2011-12-14 |
| Find all providers in zip 27596 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162061 | Lewis E Williams | Custodial Care Facility | 1640 Bridgedale Dr, Rocky Mount, NC 27803-1604 | 2020-10-26 |
| 1861008583 | Arbor Landing At Hampstead LLC | Custodial Care Facility | 13937 Us Highway 17, Hampstead, NC 28443-4041 | 2020-09-17 |
| 1124645544 | Charlotte Sp Senior Housing Opco, LLC | Custodial Care Facility | 6041 Piedmont Row Drive, Charlotte, NC 28208 | 2020-07-01 |
| 1740804111 | Happy Hearts Group Home | Custodial Care Facility | 6255 Burlington Rd, Gibsonville, NC 27249-8783 | 2020-06-02 |
| 1730703422 | Graham 4 Enterprises | Custodial Care Facility | 3006 W Sedgefield Dr, Greensboro, NC 27407-7313 | 2020-05-29 |
| 1477177111 | C&s Adult Care LLC, Dba Deal Care Inn | Custodial Care Facility | 1075 Deal Rd, Mooresville, NC 28115-6719 | 2020-05-28 |
| 1114554516 | Cassandra Davis | Custodial Care Facility | 131 Huntington Rd, Louisburg, NC 27549 | 2020-03-25 |
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1477184653 | Rose Vista Assisted Living, LLC | Custodial Care Facility | 2130 Rose Vista Rd, Kinston, NC 28504-8230 | 2020-01-28 |
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSVILLE |
| Zip Code | 27596 |
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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.