Healthcare Provider Details

I. General information

NPI: 1063616563
Provider Name (Legal Business Name): DIVINE CARE HOME HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 ERRINGER RD STE 106
SIMI VALLEY CA
93065-6527
US

IV. Provider business mailing address

1716 ERRINGER RD STE 106
SIMI VALLEY CA
93065-6527
US

V. Phone/Fax

Practice location:
  • Phone: 805-578-9481
  • Fax: 805-578-9486
Mailing address:
  • Phone: 818-332-6150
  • Fax: 805-578-9486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ARNOLD ROBLEDO BUNYE
Title or Position: DPCS
Credential: BSN RN
Phone: 805-578-9481