Healthcare Provider Details

I. General information

NPI: 1437063849
Provider Name (Legal Business Name): DIVINE TREASURY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7616 HEARTHSIDE WAY UNIT 4054
ELKRIDGE MD
21075-7621
US

IV. Provider business mailing address

7616 HEARTHSIDE WAY UNIT 4054
ELKRIDGE MD
21075-7621
US

V. Phone/Fax

Practice location:
  • Phone: 202-569-6990
  • Fax: 240-339-1770
Mailing address:
  • Phone: 202-569-6990
  • Fax: 240-339-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: SOPHIA RICHARDS SANDY
Title or Position: PRESIDENT
Credential: BA
Phone: 202-569-6990