Provider Demographics
NPI:1386405751
Name:DIVINE EXCEPTIONAL HEALTH CARE, INC.
Entity type:Organization
Organization Name:DIVINE EXCEPTIONAL HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-356-5727
Mailing Address - Street 1:2419 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19061-3611
Mailing Address - Country:US
Mailing Address - Phone:610-356-5727
Mailing Address - Fax:
Practice Address - Street 1:2419 3RD AVE
Practice Address - Street 2:
Practice Address - City:UPPER CHICHESTER
Practice Address - State:PA
Practice Address - Zip Code:19061-3611
Practice Address - Country:US
Practice Address - Phone:610-356-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health