DEVINE GRACE BEHAVIORAL HEALTH CENTER LLC NPI 1003670605

NPI Information

NPI: 1003670605
Provider Name: DEVINE GRACE BEHAVIORAL HEALTH CENTER, LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address: 85 HIGH ST
WALDORF, MD
ZIP 20602
Phone: (240) 882-0536

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NPI Details

DEVINE GRACE BEHAVIORAL HEALTH CENTER, LLC is a community behavioral health in Waldorf, MD. 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. DEVINE GRACE BEHAVIORAL HEALTH CENTER, LLC NPI is 1003670605. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

85 HIGH ST
WALDORF, MD
ZIP 20602-150
Phone: (240) 882-0536

The provider's authorized official is Adewale Soniregun .
The authorized official title is Ceo and has the following contact phone number (240) 882-0536.

The enumeration date for this NPI number is 2/13/2024 and was last updated on 8/23/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	251S00000X	Community/Behavioral Health		Yes
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
5	261QM0850X	Clinic/Center	Adult Mental Health	No
6	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No

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: 11/21/2025

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