Provider Demographics
NPI:1114718970
Name:DEVINE HOME HEALTH AGENCY LLC.
Entity type:Organization
Organization Name:DEVINE HOME HEALTH AGENCY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIQUASHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-242-6977
Mailing Address - Street 1:17325 EUCLID AVE STE 4071
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1262
Mailing Address - Country:US
Mailing Address - Phone:216-242-6977
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 4071
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1262
Practice Address - Country:US
Practice Address - Phone:216-242-6977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health