Provider Demographics
NPI:1255932737
Name:DIVINE HEART SUPPORTIVE COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:DIVINE HEART SUPPORTIVE COMMUNITY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:J
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-748-0424
Mailing Address - Street 1:424 INVESTORS PL STE 108
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1168
Mailing Address - Country:US
Mailing Address - Phone:757-748-0424
Mailing Address - Fax:804-404-9532
Practice Address - Street 1:424 INVESTORS PL STE 108
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1168
Practice Address - Country:US
Practice Address - Phone:757-748-0424
Practice Address - Fax:804-404-9532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child