Provider Demographics
NPI:1568188134
Name:DIVINE HEALING HOME CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:DIVINE HEALING HOME CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RASHIDAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-655-2428
Mailing Address - Street 1:9301 W MANOR CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-1728
Mailing Address - Country:US
Mailing Address - Phone:773-656-2528
Mailing Address - Fax:
Practice Address - Street 1:9301 W MANOR CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-1728
Practice Address - Country:US
Practice Address - Phone:773-656-2528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health