Provider Demographics
NPI:1992528350
Name:DIVINE HANDS HOME HEALTH AGENCY INC
Entity type:Organization
Organization Name:DIVINE HANDS HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LANSANA-GBONGAY
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTER NURSE
Authorized Official - Phone:952-657-9629
Mailing Address - Street 1:5701 SHINGLE CREEK PKWY STE 615A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2493
Mailing Address - Country:US
Mailing Address - Phone:952-452-1031
Mailing Address - Fax:
Practice Address - Street 1:5701 SHINGLE CREEK PKWY STE 615A
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2493
Practice Address - Country:US
Practice Address - Phone:952-452-1031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health