MEDICARE: DIVINE HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1134963879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1743 S DEQUINCY ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-3604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1743 S DEQUINCY ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-3604
Country	:	US
Telephone Number	:	317-279-6228
Fax Number	:	317-516-0816

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	PATRICE ELLIS
Credential	:
Telephone Number	:	317-294-5808

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	06/19/2024

Similar Medicare Providers

1750238424 — DEVIN CRIDER CMA,HHA
Practice Location Address:

801 SHELBY ST STE LL4
INDIANAPOLIS, IN
46203-1163

Practice Phone: 317-964-3308
Practice Fax:

1235089491 — BETTYS HELPERS LLC
Practice Location Address:

1118 HARLAN ST
INDIANAPOLIS, IN
46203-2109

Practice Phone: 317-325-8898
Practice Fax:

1699620526 — AUBREA MVALO
Practice Location Address:

695 JUSTICE WAY
INDIANAPOLIS, IN
46203-1574

Practice Phone: 317-327-1700
Practice Fax:

1033921812 — QUINN HENSLEY
Practice Location Address:

1061 E SOUTHERN AVE
INDIANAPOLIS, IN
46203-5214

Practice Phone: 463-701-0909
Practice Fax:

1598760654 — SHARON CARL LCSW
Practice Location Address:

3401 E RAYMOND ST
INDIANAPOLIS, IN
46203-4744

Practice Phone: 317-957-2100
Practice Fax:

1023010980 — CHARLES WALTER KELLEY III DPM
Practice Location Address:

3401 E RAYMOND ST
INDIANAPOLIS, IN
46203-4744

Practice Phone: 317-788-9769
Practice Fax: 317-781-4868

Directions to “DIVINE HEALTHCARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.