Provider Demographics
NPI:1528869351
Name:DIVYNE HEALTH ADULT DAY CENTER
Entity type:Organization
Organization Name:DIVYNE HEALTH ADULT DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-835-3601
Mailing Address - Street 1:6421 CHESTERFIELD MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8810
Mailing Address - Country:US
Mailing Address - Phone:804-835-3601
Mailing Address - Fax:804-248-6136
Practice Address - Street 1:6421 CHESTERFIELD MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8810
Practice Address - Country:US
Practice Address - Phone:804-835-3601
Practice Address - Fax:804-284-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care