Provider Demographics
NPI:1477732733
Name:DIVINE CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DIVINE CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISHTIAQ
Authorized Official - Middle Name:
Authorized Official - Last Name:JINNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-430-9520
Mailing Address - Street 1:5190 NW 167TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6328
Mailing Address - Country:US
Mailing Address - Phone:305-430-9520
Mailing Address - Fax:305-430-9521
Practice Address - Street 1:5190 NW 167TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33014-6328
Practice Address - Country:US
Practice Address - Phone:305-430-9520
Practice Address - Fax:305-430-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health