Organization
DIVINE INTERVENTION HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRENA A HARRIS RN (DIRECTOR OF NURSING)
(708) 248-7662
Entity
Organization
Contact information
Practice address
4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
(708) 248-7662
(708) 248-7682
Mailing address
4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
(708) 248-7662
(708) 248-7682
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2003090
IL
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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