Healthcare Provider Details

I. General information

NPI: 1871760959
Provider Name (Legal Business Name): DIVINE TOUCH HEALTH SERVICES INCORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1917 W GLENDALE AVE #5
PHX AZ
85021-7821
US

IV. Provider business mailing address

11930 W VILLA HERMOSA LANE
SUN CITY AZ
85373-5402
US

V. Phone/Fax

Practice location:
  • Phone: 602-864-5040
  • Fax: 602-864-5016
Mailing address:
  • Phone: 602-864-5040
  • Fax: 602-864-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberLP037173
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberLP037173
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLP037173
License Number StateAZ
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE ALABA OPUROKU
Title or Position: PRESIDENT
Credential: LPN
Phone: 602-864-5040