Provider Demographics
NPI:1477254001
Name:DEVINE HEALTH CARE LLC
Entity Type:Organization
Organization Name:DEVINE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EYERUSALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MESKELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-285-7139
Mailing Address - Street 1:2851 S PARKER RD STE 1-0424
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2736
Mailing Address - Country:US
Mailing Address - Phone:720-285-7139
Mailing Address - Fax:
Practice Address - Street 1:2851 S PARKER RD STE 1-0424
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2736
Practice Address - Country:US
Practice Address - Phone:720-285-7139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health