Provider Demographics
NPI:1427327170
Name:DIVINE CARE LLC
Entity type:Organization
Organization Name:DIVINE CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:HYUNG
Authorized Official - Last Name:DAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-491-2525
Mailing Address - Street 1:1214 EASTON RD STE 101G
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1788
Mailing Address - Country:US
Mailing Address - Phone:215-491-2525
Mailing Address - Fax:215-491-2524
Practice Address - Street 1:1214 EASTON RD STE 101G
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1788
Practice Address - Country:US
Practice Address - Phone:215-491-2525
Practice Address - Fax:215-491-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA22073601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health