Provider Demographics
NPI:1629412796
Name:NCHE, DIVINE (HHA)
Entity Type:Individual
Prefix:MR
First Name:DIVINE
Middle Name:
Last Name:NCHE
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 MUSKOGEE ST
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1426
Mailing Address - Country:US
Mailing Address - Phone:240-601-6788
Mailing Address - Fax:
Practice Address - Street 1:2603 MUSKOGEE ST
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1426
Practice Address - Country:US
Practice Address - Phone:240-601-6788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1795374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker