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NPI Code Detail

MEDICARE: DIVINE HELP SUPPORTED COMMUNITY LIVING LLC

MEDICARE: DIVINE HELP SUPPORTED COMMUNITY LIVING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker
2103TM1800XIntellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number : 1609713999
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVINE HELP SUPPORTED COMMUNITY LIVING LLC
Provider Business Mailing Address
First Line : 7969 CINCINNATI DAYTON RD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-6633
Country : US
Telephone Number : 502-650-6210
Fax Number : 502-650-6210
Provider Business Practice Location Address
First Line : 7969 CINCINNATI DAYTON RD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-6633
Country : US
Telephone Number : 502-650-6210
Fax Number : 502-650-6210
Authorized Official
Title or Position : CEO
Name : OLUFISAYO OLADIPUPO ISIJOLA
Credential :
Telephone Number : 502-650-6210
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “DIVINE HELP SUPPORTED COMMUNITY LIVING LLC ” Practice Location

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