Provider Demographics
NPI:1306466552
Name:DIVINE HOME CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:DIVINE HOME CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:803-840-6044
Mailing Address - Street 1:2820 MCCRAYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-6006
Mailing Address - Country:US
Mailing Address - Phone:803-840-6044
Mailing Address - Fax:
Practice Address - Street 1:533 OXFORD ST STE A
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3353
Practice Address - Country:US
Practice Address - Phone:803-840-6044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care