# DIVINE INTERVENTION HEALTHCARE, INC

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

## Provider details

- **NPI number:** 1912292806
- **Authorized official:** MRS. SANDRENA ARMETTA HARRIS RN (DIRECTOR OF NURSING)
- **Authorized official phone:** (708) 248-7662

## Contact information

- **Practice address:** 4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
- **Practice address phone:** (708) 248-7662
- **Practice address fax:** (708) 248-7682
- **Mailing address:** 4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
- **Mailing address phone:** (708) 248-7662
- **Mailing address fax:** (708) 248-7682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251F00000X | Home Infusion Agency | — | NULL | — |

## Other

- **Enumeration date:** 06/19/2011
- **Last updated:** 10/30/2012