# DIVINE COMMUNITY CARE PROVIDERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134370513
- **Authorized official:** MS. ANGELIQUE MARIA PORTER (PRESIDENT)
- **Authorized official phone:** (614) 861-0861

## Contact information

- **Practice address:** 7550 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-3156
- **Practice address phone:** (614) 861-0861
- **Practice address fax:** (614) 861-8026
- **Mailing address:** 7550 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-3156
- **Mailing address phone:** (614) 861-0861
- **Mailing address fax:** (614) 861-8026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2008
- **Last updated:** 10/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2531853 | MBS CONTRACT NUMBER | OH |
| 05 | — | 2649227 | — | OH |