1. Home
  2. Directory
  3. Maryland
  4. Rockville
  5. Clinic Center
  6. NPI Profile

DIVINE HEALTH MEDICAL AND SPA LLC
NPI 1790428555
Clinic/Center - Primary Care in Rockville, MD

Active since April 19, 2022
11119 ROCKVILLE PIKE STE 320, ROCKVILLE, MD 20852(240) 669-6598(240) 669-6079 Get Directions Write a Review

NPPES record last updated: July 14, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 14, 2022, Apr 19, 2022 (2 updates tracked since 2022).

About Divine Health Medical And Spa Llc NPPES

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

DIVINE HEALTH MEDICAL AND SPA LLC (NPI 1790428555) is a healthcare organization registered as a primary care in Rockville, Maryland and active in the NPI registry since April 2022. The organization lists Sally Owie Young, Educator, as its authorized official.

NPPES Registry Identity

NPI1790428555
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameDIVINE HEALTH MEDICAL AND SPA LLC
Location Address11119 ROCKVILLE PIKE STE 320Rockville, MD 20852-3143
Mailing Address12406 Buckley DrSilver Spring, MD 20904-2017 · (240) 437-9997 · Fax (240) 669-6079
Phone(240) 669-6598
Fax(240) 669-6079
Organization SubpartNo
Authorized OfficialSally Owie YoungEducator · (240) 437-9997
Enumeration DateApril 19, 2022
Last NPPES UpdateJuly 14, 20222 updates tracked since enumeration
NPPES CertifiedJuly 14, 2022
✔ NPI 1790428555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
11119 ROCKVILLE PIKE STE 320, Rockville, MD 20852
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

KAMIL EAR, NOSE, AND THROAT, LLC
Audiologist
11119 ROCKVILLE PIKE STE 320
ROCKVILLE, MD 20852
Montgomery County (301) 307-5050
YU AUDIOLOGY, LLC
Audiologist
11119 ROCKVILLE PIKE STE 320
ROCKVILLE, MD 20852
Montgomery County (318) 229-5781
KAMIL EAR, NOSE, AND THROAT, LLC
Otolaryngology
11119 ROCKVILLE PIKE STE 320
ROCKVILLE, MD 20852
Montgomery County (248) 421-4697

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 Medical And Spa LLC's NPI number?

The NPI number for Divine Health Medical And Spa LLC is 1790428555. It was assigned to this organization in the NPPES registry on April 19, 2022.

Where is Divine Health Medical And Spa LLC located?

Divine Health Medical And Spa LLC is located at 11119 Rockville Pike Ste 320, Rockville, MD 20852. The listed phone number is (240) 669-6598.

What is Divine Health Medical And Spa LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Divine Health Medical And Spa LLC was last updated on July 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.