MEDICARE: DIVINE HOME HEALTH SERVICES 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	:	1548615065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1577B GOODMAN AVE STE 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1004
Country	:	US
Telephone Number	:	513-860-1072
Fax Number	:	513-297-9292

Provider Business Practice Location Address
First Line	:	1577B GOODMAN AVE STE 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1004
Country	:	US
Telephone Number	:	513-860-1072
Fax Number	:	513-297-9292

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NICHOLAS GATOTO
Credential	:
Telephone Number	:	513-860-1072

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	07/25/2025

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Directions to “DIVINE HOME HEALTH SERVICES LLC ” Practice Location

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