Healthcare Provider Details

I. General information

NPI: 1295672046
Provider Name (Legal Business Name): DEVINE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 S HAMILTON RD STE 216
COLUMBUS OH
43232-4300
US

IV. Provider business mailing address

2242 S HAMILTON RD STE 216
COLUMBUS OH
43232-4300
US

V. Phone/Fax

Practice location:
  • Phone: 614-816-9081
  • Fax:
Mailing address:
  • Phone: 614-816-9081
  • 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: MR. SAM BANABAS HARRIS
Title or Position: CEO
Credential: CEO
Phone: 614-816-9081