Healthcare Provider Details

I. General information

NPI: 1780415315
Provider Name (Legal Business Name): DIVINUS HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W MAIN ST UNIT 304E
SALISBURY MD
21801-4905
US

IV. Provider business mailing address

116 W MAIN ST UNIT 304E
SALISBURY MD
21801-4905
US

V. Phone/Fax

Practice location:
  • Phone: 667-653-5145
  • Fax: 877-713-2877
Mailing address:
  • Phone: 667-653-5145
  • Fax:

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: DR. ADELINE NUKUNA
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 267-650-7880