Divine Home & Health Support LLC · Home Health Registered Nurse

30610 Woodstock St, Southfield, MI 48076-1260

Overview

Divine Home & Health Support LLC is a Home Health Registered Nurse (organization) practicing in Southfield, Michigan. The National Provider Identifier (NPI) is #1477409472, which was assigned on March 10, 2026, and the registration record was last updated on March 10, 2026. The practitioner's main practice location is at 30610 Woodstock St, Southfield, MI 48076-1260; the contact telephone number is 3139151768. The primary taxonomy of Divine Home & Health Support LLC is Home Health Registered Nurse (163WH0200X), with specialization in Home Health. The authorized official for Divine Home & Health Support LLC is Jasmine Kellum (Home Health-Rn).

Provider Information

NPI 1477409472
Entity Type Organization
Organization Name DIVINE HOME & HEALTH SUPPORT LLC
Provider Name DIVINE HOME & HEALTH SUPPORT LLC
Practice Address 30610 Woodstock St
Southfield
MI 48076-1260
Practice Telephone 3139151768
Mailing Address 30610 Woodstock St
Southfield
MI 48076-1260
Certification Date 2026-03-10
Enumeration Date 2026-03-10
Last Update Date 2026-03-10
Is Organization Subpart N

Authorized Official Information

Official Name JASMINE KELLUM
Official Title HOME HEALTH-RN
Telephone 3139151768

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y163WH0200XRegistered NurseHome Health193400000X SINGLE SPECIALTY GROUP

Taxonomy Information

Primary Taxonomy

Code 163WH0200X
Taxonomy Home Health Registered Nurse
Classification Registered Nurse
Specialization Home Health
Grouping Nursing Service Providers
Definition: Definition to come...

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Precious L Miliner 230 S Perry Rd # 1140, Plainfield, IN 46168-2735Home Health Registered Nurse2026-06-05
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Location Information

Street Address 30610 WOODSTOCK ST
City SOUTHFIELD
State MI
Zip Code 48076-1260
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Jasmine Kellum 30610 Woodstock St, Southfield, MI 48076-1260Home Health Registered Nurse2025-11-26

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Amanii S Coffman 20700 Civic Center Dr, Southfield, Mi 48076, Southfeild, MI 48076Behavior Technician2025-10-29
Stephanie Jacinta Poole 28325 Ranchwood Dr, Southfield, MI 48076Lactation Consultant (Non-RN)2023-05-05
Ahja Kianna Washington 20700 Civic Dr. Suite 110, Southfield, MI 48076Behavior Technician2025-07-08
Millennial Infusion Centers Inc 26250 Northwestern Hwy Ste 201, Southfield, MI 48076Infusion Therapy Clinic/Center2018-11-27
Marian Hannah Ibrahim 19189 W 12 Mile Rd, Lathrup Village, MI 48076Dentist2020-07-09
Gracen Elizabeth Minor 21311 Civic Center Drive, Southfield, MI 48076Physician Assistant2025-06-05
Wilbert T Williams 29433 Southfield Rd, Suite 208 Room 8, Southfield, MI 48076Massage Therapist2021-07-19
Empowerment Pathways Counseling 28475 Greenfield Rd., Suite 113 Pmb 1004, Southfield, MI 48076Mental Health Clinic/Center (Including Community Mental Health Center)2020-12-30
Mavis Gail Pookrum 21732 Colony Park Circle #105, Southfield, MI 48076Personal Care Attendant2018-11-28
Amanda M Booth 20700 Civic Dr, Southfield, MI 48076Behavior Technician2026-01-16
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Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
Divine Health Systems, Inc 1900 E Northern Pkwy Ste 210, Baltimore, MD 21239-2192Mental Health Clinic/Center (Including Community Mental Health Center)2026-05-20
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Divine Timing Health Care Support, LLC 101 S Lowry St Apt 7001, Smyrna, TN 37167-3485In Home Supportive Care Agency2026-05-11
Revival Home Support L.L.C 8725 Wellesley Lake Dr Apt 203, Orlando, FL 32818-6303In Home Supportive Care Agency2026-04-08
Softline Home Support 547 E Lee St, Dawson, GA 39842-1555Case Manager/Care Coordinator2026-04-18
Divine Supreme Home Care LLC 1039 Walnut Ln, Lansdale, PA 19446-4505Home Health Agency2026-05-19
Divine Providence Health Services 7600 Georgia Ave Nw Ste 412, Washington, DC 20012-1616Addiction (Substance Use Disorder) Counselor2026-03-26
Advanced Support Home Health LLC 3200 N 5th St, Philadelphia, PA 19140-5612In Home Supportive Care Agency2026-03-17
Divine Design Health 3662 Regal Pl, Los Angeles, CA 90068-1230Health & Wellness Coach2026-05-05
Divine Wonders Home Care, LLC 2205 Crestwood Ridge Dr, Durham, NC 27704-6144Home Health Agency2026-03-18

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.