Divine Redemption Llc

LBN: Divine Redemption Llc
Divine Redemption Llc is an health care organization with primary practice located at 112 W Broadway Suite A, Bolivar MO 65613. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty. Divine Redemption Llc can be contacted via phone (417) 296-4140, or through Divine, Brandy via phone (417) 296-4140.

Contact Information

Primary practice address
112 W Broadway Suite A Bolivar MO 65613
Phone: (417) 296-4140
Fax: (417) 326-0022
Website:
Map and Directions
Authorized official contact:
Name: Divine, Brandy DNP
Phone: (417) 296-4140

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1790536142
LBN Legal business name Divine Redemption Llc
DBA Doing business as
Authorized official Divine, Brandy DNP
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2024
Last updated Apr 1st, 2024 - about 7 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.

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