Organization
DIVINE HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHEYENNE ELAINE SHIPMAN PMHNP-BC (OWNER)
(719) 413-5261
Entity
Organization
Contact information
Practice address
1206 E 3RD ST, LA JUNTA, CO 81050-1907
(719) 413-5261
Mailing address
1206 E 3RD ST, LA JUNTA, CO 81050-1907
(719) 413-5261
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285128413
—
CO
Enumeration date
02/22/2023
Last updated
07/18/2025
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