MEDICARE: DIVINEWORK HOMECARE OH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	347C00000X	Private Vehicle
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1790524346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINEWORK HOMECARE OH LLC

Provider Business Mailing Address
First Line	:	1876 TOURNAMENT WAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-7597
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1876 TOURNAMENT WAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-7597
Country	:	US
Telephone Number	:	201-914-2225
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SWETA PATEL
Credential	:
Telephone Number	:	201-914-2225

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	02/07/2025

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Directions to “DIVINEWORK HOMECARE OH LLC ” Practice Location

Language	Start Address	Practice Location

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