DIVINE HEALTHCARE NPI 1780349639

NPI Information

  • NPI: 1780349639
  • Provider Name: DIVINE HEALTHCARE
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 1778 GRANDE VIEW AVE
    SEVERN, MD
    ZIP 21144
  • Phone: (410) 551-5849

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NPI Details

DIVINE HEALTHCARE is a mental health (including community mental health center) clinic center in Severn, MD. DIVINE HEALTHCARE NPI is 1780349639. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1778 GRANDE VIEW AVE
SEVERN, MD
ZIP 21144-333
Phone: (410) 551-5849
Fax: (410) 551-0685

The provider's authorized official is Abimbola Hillard .
The authorized official title is President and has the following contact phone number (410) 551-5849.

The enumeration date for this NPI number is 11/5/2021 and was last updated on 11/5/2021.

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 Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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: 3/30/2025

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