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General NPI Number Information
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NPI Number | 1538915020
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Entity Type | Organization
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Legal Business Name | DIVINE HOME HEALTH CARE AGENCY LLC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 811 MARKET ST
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City | GLOUCESTER CITY
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State | NJ
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Zip | 08030-1811
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Country | US
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Telephone | 973-563-2139
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Fax |
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Provider Business Mailing Address
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Address Line | 9 NUTMEG DR
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City | LUMBERTON
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State | NJ
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Zip | 08048-4218
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Country | US
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Telephone | 973-563-2139
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. AKIN BRAIMAH
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Credential |
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Telephone | 973-563-2139
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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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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 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 #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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