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General NPI Number Information
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NPI Number | 1811549249
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Entity Type | Organization
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Legal Business Name | DIVINE HOME HEALTH CARE
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 220 DAVIDSON AVE STE 105
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City | SOMERSET
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State | NJ
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Zip | 08873-4113
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Country | US
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Telephone | 732-300-8371
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Fax |
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Provider Business Mailing Address
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Address Line | 220 DAVIDSON AVE STE 105
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City | SOMERSET
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State | NJ
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Zip | 08873-4113
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Country | US
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Telephone | 732-300-8371
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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. GREGORY ENABOSI
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Credential |
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Telephone | 732-300-8371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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