# DIVINE HEALTHCARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1255618716
- **Authorized official:** MR. EGHOSA E ODOBO RN (PRESIDENT)
- **Authorized official phone:** (678) 358-4681

## Contact information

- **Practice address:** 903 SHAFTOE ST NW, KENNESAW, GA 30152-6999
- **Practice address phone:** (678) 612-1700
- **Mailing address:** 903 SHAFTOE ST NW, KENNESAW, GA 30152-6999
- **Mailing address phone:** (678) 612-1700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 033-R-0348 | GA | Yes |

## Other

- **Enumeration date:** 11/11/2011
- **Last updated:** 11/11/2011