Provider Demographics
NPI:1518630854
Name:DIVINE HOPE HOME CARE LLC
Entity Type:Organization
Organization Name:DIVINE HOPE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:NJOTEH
Authorized Official - Last Name:WENJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-396-8433
Mailing Address - Street 1:2965 DACULA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1180
Mailing Address - Country:US
Mailing Address - Phone:520-396-8433
Mailing Address - Fax:
Practice Address - Street 1:2965 DACULA OAKS DR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1180
Practice Address - Country:US
Practice Address - Phone:520-396-8433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health