DIVINE PURPOSE SERVICES LIMITED LLC NPI 1174897391

NPI Information

NPI: 1174897391
Provider Name: DIVINE PURPOSE SERVICES LIMITED LLC
Classification: Private Vehicle - 347C00000X
Entity Type: Organization

CLIA Number: 34D2263683

Address:
810 W DIXON BLVD STE 2
SHELBY, NC
ZIP 28152
Phone: (704) 300-5544
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DIVINE PURPOSE SERVICES LIMITED LLC is a private vehicle in Shelby, NC. The provider is an individual paid to provide non-emergency transportation using their privately owned/leased vehicle. DIVINE PURPOSE SERVICES LIMITED LLC NPI is 1174897391. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

810 W DIXON BLVD STE 2
SHELBY, NC
ZIP 28152-103
Phone: (704) 300-5544
Fax: (704) 270-9504

The provider's authorized official is Brandy N Ussery .
The authorized official title is Owner and has the following contact phone number (704) 300-5544.

The CLIA number assigned to this NPI record is 34D2263683 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2012 and was last updated on 4/10/2023.

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	License State	Primary
1	101YP2500X	Counselor	Professional	NORTH CAROLINA	No
2	171M00000X	Case Manager/Care Coordinator			No
3	207R00000X	Internal Medicine		NORTH CAROLINA	No
4	2084P0800X	Psychiatry & Neurology	Psychiatry		No
5	251S00000X	Community/Behavioral Health			No
6	261QA0600X	Clinic/Center	Adult Day Care		No
7	261QM0855X	Clinic/Center	Adolescent and Children Mental Health		No
8	291U00000X	Clinical Medical Laboratory			No
9	347C00000X	Private Vehicle			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0	MEDICAID	NORTH CAROLINA
2	90050524	MEDICAID	SOUTH 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: 5/5/2024

NPI Synchronization or Removal

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