Healthcare Provider Details

I. General information

NPI: 1972413805
Provider Name (Legal Business Name): DIVINE HOPE CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 BLACKPOOL DR
ANTIOCH TN
37013-4688
US

IV. Provider business mailing address

149 BLACKPOOL DR
ANTIOCH TN
37013-4688
US

V. Phone/Fax

Practice location:
  • Phone: 615-955-8177
  • Fax:
Mailing address:
  • Phone: 615-955-8177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: AUGUSTINA C DURUNNA
Title or Position: OWNER/MANAGING MEMBER CEO
Credential: PMHNP-BC
Phone: 615-955-8177