Provider Demographics
NPI:1871645523
Name:DIVINE NURSES HEALTH SERVICES INC
Entity Type:Organization
Organization Name:DIVINE NURSES HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IREBE
Authorized Official - Middle Name:NTEPEL
Authorized Official - Last Name:MUTII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-655-5566
Mailing Address - Street 1:827 N TATNALL ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1744
Mailing Address - Country:US
Mailing Address - Phone:302-655-5566
Mailing Address - Fax:302-655-5567
Practice Address - Street 1:827 N TATNALL ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1744
Practice Address - Country:US
Practice Address - Phone:302-655-5566
Practice Address - Fax:302-655-5567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2007011632842251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health