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General NPI Number Information
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NPI Number | 1215177332
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Entity Type | Organization
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Legal Business Name | DIVINE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 3375 VALLEY PARK AVE
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City | COLUMBUS
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State | OH
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Zip | 43231-6123
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Country | US
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Telephone | 614-432-6620
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Fax | 614-470-9676
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Provider Business Mailing Address
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Address Line | 3375 VALLEY PARK AVE
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City | COLUMBUS
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State | OH
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Zip | 43231-6123
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Country | US
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Telephone | 614-432-6620
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Fax | 614-470-9676
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MARY W MUCHENE
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Credential | RN, BSN
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Telephone | 614-432-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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