Provider Demographics
NPI:1437839586
Name:DIVENTURA, AMALVIA (NJ CERTIFIED HHA)
Entity Type:Individual
Prefix:MS
First Name:AMALVIA
Middle Name:
Last Name:DIVENTURA
Suffix:
Gender:F
Credentials:NJ CERTIFIED HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMALVIA DIVENTURA
Mailing Address - Street 2:PO BOX 2284
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-0951
Mailing Address - Country:US
Mailing Address - Phone:609-980-8420
Mailing Address - Fax:
Practice Address - Street 1:100 SPRINGDALE ROAD
Practice Address - Street 2:A3-221
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:609-980-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NH19125800374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450695975OtherNJ DEPT OF TREAS DIV OF REVENUE & ENTERPRISE SERVICES
NJ2018122POtherACA AMERICAN CAREGIVER ASSOCIATION NCCHHA
NJ26NH19125800OtherNJ BOARD OF NURSING HHA CERTIFICATION