Healthcare Provider Details

I. General information

NPI: 1760214373
Provider Name (Legal Business Name): DIVINITY CARE AND COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21306 FRANKLIN RD
MAPLE HEIGHTS OH
44137-2134
US

IV. Provider business mailing address

21306 FRANKLIN RD
MAPLE HEIGHTS OH
44137-2134
US

V. Phone/Fax

Practice location:
  • Phone: 216-816-6174
  • Fax:
Mailing address:
  • Phone: 216-816-6174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DOMONIQUE NICOLE MORTON
Title or Position: OWNER/ OPERATOR
Credential:
Phone: 216-816-6174