Provider Demographics
NPI:1013239698
Name:CHIKA DIVINE CARE INC
Entity Type:Organization
Organization Name:CHIKA DIVINE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENEDICTA
Authorized Official - Middle Name:CHIKA
Authorized Official - Last Name:MLEMCHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:410-265-9502
Mailing Address - Street 1:1808 WOODLAWN DR STE S
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4023
Mailing Address - Country:US
Mailing Address - Phone:410-265-9502
Mailing Address - Fax:410-265-9504
Practice Address - Street 1:1808 WOODLAWN DR STE S
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4023
Practice Address - Country:US
Practice Address - Phone:410-265-9502
Practice Address - Fax:410-265-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2853P253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care