Provider Demographics
NPI:1457165540
Name:DIVINE SOLUTIONS CENTER, LLC
Entity type:Organization
Organization Name:DIVINE SOLUTIONS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMEIKA
Authorized Official - Middle Name:SHONDA
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, PMHNP-BC
Authorized Official - Phone:216-702-5616
Mailing Address - Street 1:20875 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2318
Mailing Address - Country:US
Mailing Address - Phone:216-702-5616
Mailing Address - Fax:
Practice Address - Street 1:20875 MILLER AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-2318
Practice Address - Country:US
Practice Address - Phone:216-702-5616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty