Provider Demographics
NPI:1437737236
Name:DIVINE FOREVER CARE LLC
Entity Type:Organization
Organization Name:DIVINE FOREVER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-707-6965
Mailing Address - Street 1:3190 S VAUGHN WAY STE 550
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3538
Mailing Address - Country:US
Mailing Address - Phone:702-707-6965
Mailing Address - Fax:
Practice Address - Street 1:3190 S VAUGHN WAY STE 550
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3538
Practice Address - Country:US
Practice Address - Phone:702-707-6965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care