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General NPI Number Information
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NPI Number | 1255932737
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Entity Type | Organization
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Legal Business Name | DIVINE HEART SUPPORTIVE COMMUNITY SERVICES LLC
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 424 INVESTORS PL STE 108
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1168
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Country | US
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Telephone | 757-748-0424
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Fax | 804-404-9532
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Provider Business Mailing Address
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Address Line | 424 INVESTORS PL STE 108
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1168
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Country | US
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Telephone | 757-748-0424
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Fax | 804-404-9532
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MARGARET J HINES
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Credential |
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Telephone | 757-748-0424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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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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