DIVINE LEGACY – Mental Health Clinic/Center (Including Community Mental Health Center), NPI 1073072260

DIVINE LEGACY is a healthcare provider. based in Brooklyn center, Minnesota. specializing in Mental Health Clinic/Center (Including Community Mental Health Center). The NPI Number for DIVINE LEGACY is 1073072260

Main info

Organization
Name
DIVINE LEGACY
NPI
1073072260
Phone
(763) 439-2588
Address
3300 COUNTY ROAD 10 STE 318
Authorized Official
LAKESIA AYCOCK ADMINISTRATION/MHP
Enumeration Date
18 March 2019
Last Update Date
18 March 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness75
Years active:7State licenses:0Digital endpointsOther names

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Provider Addresses for DIVINE LEGACY

  • County Road 10, Brooklyn Center, Hennepin County, Minnesota, 55430, United States

    BROOKLYN CENTER, MN 554293066

    Phone: (763) 439-2588

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55429)

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Reviews

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Frequently asked questions

What is the registry number for DIVINE LEGACY?
The registry entry for DIVINE LEGACY shows NPI 1073072260.
Quick check: is DIVINE LEGACY active?
Public NPPES data shows DIVINE LEGACY with an active NPI status right now.
What does the directory say DIVINE LEGACY does?
Insurance directories may phrase it differently, but here DIVINE LEGACY maps to Mental Health Clinic/Center (Including Community Mental Health Center). Clinical services aligned with this taxonomy classification.
What geographic area is tied to DIVINE LEGACY?
DIVINE LEGACY is associated with Brooklyn Center, Minnesota in the same public data insurers reference.
Who maintains DIVINE LEGACY's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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