Provider Demographics
NPI:1740316447
Name:DIVINA PRESENCIA HOSPICE, INC.
Entity type:Organization
Organization Name:DIVINA PRESENCIA HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-775-8000
Mailing Address - Street 1:DIVINA PRESENCIA HOSPICE, INC.
Mailing Address - Street 2:PMB # 94 PO BX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0000
Mailing Address - Country:US
Mailing Address - Phone:787-775-8000
Mailing Address - Fax:787-775-8022
Practice Address - Street 1:876 CALLE 27 SW
Practice Address - Street 2:ESQ. AMERICO MIRANDA, URB. LAS LOMAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921-2421
Practice Address - Country:US
Practice Address - Phone:787-775-8000
Practice Address - Fax:787-775-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR401547Medicare Oscar/Certification