Divine Healthcare Services

LBN: Divine Healthcare Services
Divine Healthcare Services is an health care organization with primary practice located at 4238 W Hawthorne Trace Rd Apt 104 , Brown Deer WI 53209-1026. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Divine Healthcare Services can be contacted via phone (414) 975-0121, or through Omereonye, Gold via phone (414) 975-0121.

Contact Information

Primary practice address
4238 W Hawthorne Trace Rd Apt 104 Brown Deer WI 53209-1026
Phone: (414) 975-0121
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Omereonye, Gold
Phone: (414) 975-0121

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 126208-30 Wisconsin

Profile Details

NPI number 1982999090
LBN Legal business name Divine Healthcare Services
DBA Doing business as
Authorized official Omereonye, Gold
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2011
Last updated Jun 16th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982999090 NPPES
Texas Other 271904077 IRS

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