Provider Demographics
NPI:1083061378
Name:DIVINE GRACE NON MEDICAL HOME CARE SERVICES
Entity Type:Organization
Organization Name:DIVINE GRACE NON MEDICAL HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-251-8634
Mailing Address - Street 1:107 WYNVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-1032
Mailing Address - Country:US
Mailing Address - Phone:412-474-3238
Mailing Address - Fax:412-474-3261
Practice Address - Street 1:8668 PEEBLES RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5722
Practice Address - Country:US
Practice Address - Phone:412-318-4925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27273601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care