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General NPI Number Information
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NPI Number | 1801195151
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Entity Type | Organization
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Legal Business Name | DIVINE TOUCH HEALTHCARE
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 19350 S. HARLEM AVENUE SUITE 203
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-464-8069
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Fax | 815-464-8089
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Provider Business Mailing Address
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Address Line | 19350 S. HARLEM AVENUE SUITE 201
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-464-8069
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Fax | 815-464-8089
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RAYMOND A. IGE
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Credential | RN
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Telephone | 708-798-7797
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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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