Healthcare Provider Details

I. General information

NPI: 1932912078
Provider Name (Legal Business Name): DIVINE TRANSPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8136 OLD KEENE MILL RD STE A207
SPRINGFIELD VA
22152-1843
US

IV. Provider business mailing address

8136 OLD KEENE MILL RD STE A207
SPRINGFIELD VA
22152-1843
US

V. Phone/Fax

Practice location:
  • Phone: 571-318-3809
  • Fax:
Mailing address:
  • Phone: 571-318-3809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: IRIS I ALICEA TORRES
Title or Position: OWNER/MSW
Credential:
Phone: 571-318-3809