Provider Demographics
NPI:1790395010
Name:DIVINE SOLUTIONS
Entity Type:Organization
Organization Name:DIVINE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:NWANYIEZE
Authorized Official - Last Name:IDOWU
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:214-270-5784
Mailing Address - Street 1:7844 SUNHAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7844 SUNHAVEN WAY
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-1613
Practice Address - Country:US
Practice Address - Phone:214-270-5784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1780202887Other1780202887