Provider Demographics
NPI:1669990925
Name:DIVINE TOUCH RESIDENTIAL CARE SERVICES AGENCY
Entity type:Organization
Organization Name:DIVINE TOUCH RESIDENTIAL CARE SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MS
Authorized Official - First Name:EBERECHI
Authorized Official - Middle Name:EDITH
Authorized Official - Last Name:UCHEGBUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-678-5818
Mailing Address - Street 1:15209 LORD HOWE WAY
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-7204
Mailing Address - Country:US
Mailing Address - Phone:240-678-5818
Mailing Address - Fax:
Practice Address - Street 1:15209 LORD HOWE WAY
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-7204
Practice Address - Country:US
Practice Address - Phone:240-678-5818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health