Provider Demographics
NPI:1902610082
Name:DIVINE LIFTING HOME CARE LLC
Entity type:Organization
Organization Name:DIVINE LIFTING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:I
Authorized Official - Last Name:JIMBOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-970-2265
Mailing Address - Street 1:924 PINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8883
Mailing Address - Country:US
Mailing Address - Phone:682-970-2265
Mailing Address - Fax:
Practice Address - Street 1:924 PINEBROOK DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8883
Practice Address - Country:US
Practice Address - Phone:682-970-2265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care