# DIVINE CARE HOME HEALTH AGENCY

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

## Provider details

- **NPI number:** 1740597996
- **Authorized official:** MRS. LOLITA M DE LEON BSN, RN (ADMINISTRATOR)
- **Authorized official phone:** (847) 990-0893

## Contact information

- **Practice address:** 281 N SEYMOUR AVE, SUITE 100, MUNDELEIN, IL 60060-2300
- **Practice address phone:** (847) 949-4104
- **Practice address fax:** (847) 949-4116
- **Mailing address:** 281 N SEYMOUR AVE, SUITE 100, MUNDELEIN, IL 60060-2300
- **Mailing address phone:** (847) 949-4104
- **Mailing address fax:** (847) 949-4116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1011246 | IL | Yes |

## Other

- **Enumeration date:** 09/09/2010
- **Last updated:** 09/09/2010