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DIVINE LIGHT RESIDENTIAL TREATMENT LLC
NPI 1962147082
Substance Abuse Rehabilitation Facility in Baltimore, MD

Active since May 03, 2022
1200 W BALTIMORE ST, BALTIMORE, MD 21223(267) 278-1079 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Divine Light Residential Treatment Llc NPPES

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

DIVINE LIGHT RESIDENTIAL TREATMENT LLC (NPI 1962147082) is a healthcare organization registered as a substance abuse rehabilitation facility in Baltimore, Maryland and active in the NPI registry since May 2022. The organization lists Sakina Dean, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1962147082
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameDIVINE LIGHT RESIDENTIAL TREATMENT LLC
Location Address1200 W BALTIMORE STBaltimore, MD 21223-2601
Mailing Address1200 W Baltimore StBaltimore, MD 21223-2601
Phone(267) 278-1079
Organization SubpartNo
Authorized OfficialSakina DeanChief Executive Officer · (267) 278-1079
Enumeration DateMay 3, 2022
NPPES CertifiedMay 3, 2022
✔ NPI 1962147082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
1200 W BALTIMORE ST, Baltimore, MD 21223
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Other Identifiers 1

Medicaid577023800MD

Other Providers at the Same Location NPPES 4

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

DIVINE LIGHT RESIDENTIAL TREATMENT LLC
Substance Abuse Rehabilitation Facility
1200 W BALTIMORE ST
BALTIMORE, MD 21223
Baltimore City (667) 309-7643
SAKINA PARKS
Substance Abuse Rehabilitation Facility
1200 W BALTIMORE ST
BALTIMORE, MD 21223
Baltimore City (667) 309-7643
COLLABORATIVE CONCEPTS OF MARYLAND, LLC
Community/Behavioral Health
1200 W BALTIMORE ST, SUITE 202 AND 204
BALTIMORE, MD 21223
Baltimore City (443) 873-8258
DIVINE LIGHT RESIDENTIAL TREATMENT LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
1200 W BALTIMORE ST
BALTIMORE, MD 21223
Baltimore City (667) 309-7643

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 Light Residential Treatment LLC's NPI number?

The NPI number for Divine Light Residential Treatment LLC is 1962147082. It was assigned to this organization in the NPPES registry on May 3, 2022.

Where is Divine Light Residential Treatment LLC located?

Divine Light Residential Treatment LLC is located at 1200 W Baltimore St, Baltimore, MD 21223. The listed phone number is (267) 278-1079.

What is Divine Light Residential Treatment LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Divine Light Residential Treatment LLC was last updated on May 3, 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.