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PETER-ELST LLC NPI 1962809152


NPI Information

NPI: 1962809152
Provider Name: PETER-ELST LLC

Doing Business As: DIVINE SUPPORTBEDGE HEALTHCARE SERVICES.

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
3700 LYCKAN PKWY STE A
DURHAM, NC
ZIP 27707
Phone: (919) 401-6655
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PETER-ELST LLC is a community behavioral health in Durham, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. PETER-ELST LLC NPI is 1962809152. The provider is registered as an organization entity type.
The provider Is Doing Business As Divine Supportbedge Healthcare Services..

The provider's business location address is:

3700 LYCKAN PKWY STE A
DURHAM, NC
ZIP 27707-587
Phone: (919) 401-6655

The provider's authorized official is Olayide Olaniyan .
The authorized official title is Ceo and has the following contact phone number (919) 401-6655.

The enumeration date for this NPI number is 12/3/2014 and was last updated on 3/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthNORTH CAROLINAYes
2251S00000XCommunity/Behavioral HealthNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13418993MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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