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General NPI Number Information
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NPI Number | 1477497733
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Entity Type | Organization
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Legal Business Name | DIVINE HOPE HOMES LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 1720 WILDWOOD PL NE
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City | KEIZER
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State | OR
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Zip | 97303-2447
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Country | US
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Telephone | 503-390-1105
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Fax | 503-990-6285
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Provider Business Mailing Address
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Address Line | 1720 WILDWOOD PL NE
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City | KEIZER
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State | OR
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Zip | 97303-2447
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Country | US
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Telephone | 503-390-1105
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Fax | 503-990-6285
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Authorized Official
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Title or Position | DIRECTOR
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Name | DIVINE KWIZERA
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Credential |
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Telephone | 701-390-8728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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