# DIVINE TEAM HOMECARE LLC

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

## Provider details

- **NPI number:** 1407318868
- **Authorized official:** BLESSING ANYAIWE ONYEKACHI RN (ADMINISTRATOR)
- **Authorized official phone:** (678) 687-6141

## Contact information

- **Practice address:** 1895 BARRETT KNOLL CT NW, KENNESAW, GA 30152-8228
- **Practice address phone:** (678) 687-6141
- **Practice address fax:** (678) 398-7301
- **Mailing address:** 1895 BARRETT KNOLL CT NW, KENNESAW, GA 30152-8228
- **Mailing address phone:** (678) 687-6141
- **Mailing address fax:** (678) 398-7301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 04/04/2019
- **Last updated:** 04/04/2019