Provider Demographics
NPI:1780470757
Name:DIVINE CORE LLC
Entity type:Organization
Organization Name:DIVINE CORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:GATOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-685-4754
Mailing Address - Street 1:116 SUMMIT TER APT 73
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2275
Mailing Address - Country:US
Mailing Address - Phone:469-685-4754
Mailing Address - Fax:469-685-4754
Practice Address - Street 1:116 SUMMIT TER APT 73
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2275
Practice Address - Country:US
Practice Address - Phone:469-685-4754
Practice Address - Fax:469-685-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care