Healthcare Provider Details

I. General information

NPI: 1578353496
Provider Name (Legal Business Name): DIVINE HEALING HEARTS & SOULS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BELAIRE AVE STE 210 OFFICE NUMBER 2702
CHESAPEAKE VA
23320-4783
US

IV. Provider business mailing address

555 BELAIRE AVE STE 210
CHESAPEAKE VA
23320-4783
US

V. Phone/Fax

Practice location:
  • Phone: 757-819-7246
  • Fax:
Mailing address:
  • Phone: 757-819-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JOSEPHINE ELLEN BRAHAM
Title or Position: ADMINSTRATOR
Credential:
Phone: 757-618-4732