DIVINE HEALTH GROUP LLC
NPI 1164120796
Clinic/Center - Mental Health (Including Community Mental Health Center) in La Junta, CO
About Divine Health Group Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIVINE HEALTH GROUP LLC (NPI 1164120796) is a healthcare organization registered as a mental health (including community mental health center) in La Junta, Colorado and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through March 12, 2027 and lists Cheyenne Elaine Shipman, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 06D2278120
Divine Health Group · La Junta, COOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LA JUNTA, CO 81050
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Divine Health Group LLC's NPI number?
The NPI number for Divine Health Group LLC is 1164120796. It was assigned to this organization in the NPPES registry on February 22, 2023.
Where is Divine Health Group LLC located?
Divine Health Group LLC is located at 1206 E 3rd St, La Junta, CO 81050. The listed phone number is (719) 413-5261.
What is Divine Health Group LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Does Divine Health Group LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 06D2278120) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Divine Health Group LLC was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Divine Health Group Llc · NPI 1164120796
Mental Health (Including Community Mental Health Center) organization in La Junta, Colorado. Organization record, active in the CMS NPPES registry since February 22, 2023.
## Identity
- **NPI:** 1164120796 (Entity type: Organization)
- **Enumerated:** February 22, 2023
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Cheyenne Shipman, OWNER
## Practice location
- **Address:** 1206 E 3RD ST, La Junta, CO 81050-1907
- **Phone:** (719) 413-5261
## Record status
- **NPPES last updated:** July 18, 2025
- **Other identifiers:** Medicaid 1285128413 (CO)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1164120796) · Data from the CMS NPPES public registry.