Provider Demographics
NPI:1265054290
Name:DEVINE HOME AND HEALTH,LLC
Entity type:Organization
Organization Name:DEVINE HOME AND HEALTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:954-451-1844
Mailing Address - Street 1:5801 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5918
Mailing Address - Country:US
Mailing Address - Phone:754-214-1510
Mailing Address - Fax:
Practice Address - Street 1:5801 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-5918
Practice Address - Country:US
Practice Address - Phone:754-214-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health