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Organization
DIVINITY HEALTHCARE SERVICES PLLC
Active
Organization
DIVINITY HEALTHCARE SERVICES PLLC
Active
Other names
Divinity
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY DONALD ROBERTS LPN, WCN (OWNER)
(208) 546-2051
Entity
Organization
Contact information
Practice address
620 S ELDER ST, NAMPA, ID 83686-5212
(208) 546-2051
(208) 329-7001
Mailing address
620 S ELDER ST, NAMPA, ID 83686-5212
(208) 546-2051
(208) 329-7001
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
305R00000X
Preferred Provider Organization
—
ID
Other
Enumeration date
06/02/2014
Last updated
05/08/2019
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