Divine Innovation Services

LBN: Divine Innovation Services Llc
Divine Innovation Services is an health care organization with primary practice located at 120 Capcom Ave Ste 102B , Wake Forest NC 27587-6537. The organization recently has 8 registered licenses in different health care specialties including Agencies / Home Health, Agencies / In Home Supportive Care, Transportation Services / Non-emergency Medical Transport (VAN), Respite Care Facility / Respite Care, Respite Care Facility / Respite Care Camp, Respite Care Facility / Respite Care, Mental Illness, Child, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Physical Disabilities, Child. Agencies / In Home Supportive Care is the primary health care specialty. Divine Innovation Services Llc can be contacted via phone (919) 675-8937, or through Pearsall, Tracie Lanae via phone (919) 675-8937.

Contact Information

Primary practice address
120 Capcom Ave Ste 102B Wake Forest NC 27587-6537
Phone: (919) 675-8937
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pearsall, Tracie Lanae
Phone: (919) 675-8937

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X
Agencies / In Home Supportive Care 253Z00000X
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X
Respite Care Facility / Respite Care 385H00000X
Respite Care Facility / Respite Care Camp 385HR2050X
Respite Care Facility / Respite Care, Mental Illness, Child 385HR2055X
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X
Respite Care Facility / Respite Care, Physical Disabilities, Child 385HR2065X

Profile Details

NPI number 1578324141
LBN Legal business name Divine Innovation Services Llc
DBA Doing business as Divine Innovation Services
Authorized official Pearsall, Tracie Lanae
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2024
Last updated Jun 20th, 2024 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers