Provider Demographics
NPI:1801195151
Name:DIVINE TOUCH HEALTHCARE
Entity Type:Organization
Organization Name:DIVINE TOUCH HEALTHCARE
Other - Org Name:DIVINE TOUCH HEALTHCARE, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:IGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-798-7797
Mailing Address - Street 1:19350 S. HARLEM AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423
Mailing Address - Country:US
Mailing Address - Phone:815-464-8069
Mailing Address - Fax:815-464-8089
Practice Address - Street 1:19350 S. HARLEM AVENUE
Practice Address - Street 2:SUITE 203
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423
Practice Address - Country:US
Practice Address - Phone:815-464-8069
Practice Address - Fax:815-464-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health