# DIVINE HOME CARE SERVICES

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

## Provider details

- **NPI number:** 1720817067
- **Authorized official:** ADDIE OLANIYAN (AGENCY MANAGER)
- **Authorized official phone:** (708) 832-3000

## Contact information

- **Practice address:** 4351 INLET DR, STOCKTON, CA 95219-4992
- **Practice address phone:** (708) 832-3000
- **Practice address fax:** (708) 321-8219
- **Mailing address:** 1461 RING RD, CALUMET CITY, IL 60409-5459

## Taxonomy

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

## Other

- **Enumeration date:** 07/26/2024
- **Last updated:** 07/26/2024