DIVINE LIGHT
NPI 1427608611
Community/Behavioral Health in Baltimore, MD

Q: What is Divine Light's NPI number?

The NPI number for Divine Light is 1427608611. It was assigned to this organization in the NPPES registry on September 19, 2019.

Q: What is Divine Light's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Q: When was this NPI record last updated?

The NPPES record for Divine Light was last updated on September 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since September 19, 2019CLIA 21D2338491 · Waiver

2211 MARYLAND AVE, BALTIMORE, MD 21218(443) 552-1460 Get Directions Write a Review

NPPES record last updated: September 19, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Divine Light NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINE LIGHT (NPI 1427608611) is a healthcare organization registered as a community/behavioral health in Baltimore, Maryland and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through February 10, 2028 and lists Sakina Parks, Ceo, as its authorized official.

NPPES Registry Identity

NPI1427608611

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameDIVINE LIGHT

Location Address2211 MARYLAND AVEBaltimore, MD 21218-5627

Mailing Address2211 Maryland AveBaltimore, MD 21218-5627 · (443) 552-1460

Phone(443) 552-1460

Organization SubpartYes

Authorized OfficialSakina ParksCeo · (443) 552-1460

Enumeration DateSeptember 19, 2019

✔ NPI 1427608611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

2211 MARYLAND AVE, Baltimore, MD 21218

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Other Identifiers 1

Medicaid270019100MD

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 21D2338491

Divine Light Residential Treatment · Baltimore, MD

Active · expires Feb 10, 2028

CLIA Number21D2338491

Laboratory TypePractitioner Other

Certificate Effective DateFebruary 11, 2026

Certificate Expiration DateFebruary 10, 2028

Laboratory DirectorSylvester Wilson

Laboratory Phone(443) 552-1460

Laboratory LocationDivine Light Residential Treatment1200 W Baltimore St, Baltimore, MD 21223

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUDACITY OF HOPE BEHAVIORAL HEALTH

Clinical Medical Laboratory