Provider Demographics
NPI:1083256036
Name:DEVINE HOSPICE CARE, INC.
Entity type:Organization
Organization Name:DEVINE HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAREAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-616-3032
Mailing Address - Street 1:20945 DEVONSHIRE ST STE 201C
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2370
Mailing Address - Country:US
Mailing Address - Phone:818-616-3032
Mailing Address - Fax:844-273-0762
Practice Address - Street 1:20945 DEVONSHIRE ST STE 201C
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2370
Practice Address - Country:US
Practice Address - Phone:818-616-3032
Practice Address - Fax:844-273-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based