Provider Demographics
NPI:1992208599
Name:DIVINE TOUCH HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:DIVINE TOUCH HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OPEYEMI
Authorized Official - Middle Name:ABOSEDE
Authorized Official - Last Name:ODUMERU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-889-6676
Mailing Address - Street 1:7809 WINTER HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-1446
Mailing Address - Country:US
Mailing Address - Phone:443-889-6676
Mailing Address - Fax:
Practice Address - Street 1:7809 WINTER HAVEN RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-1446
Practice Address - Country:US
Practice Address - Phone:443-889-6676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-10
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4134251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health