Organization
DIVINE CARE HOME HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOLITA M DE LEON BSN, RN (ADMINISTRATOR)
(847) 990-0893
Entity
Organization
Contact information
Practice address
281 N SEYMOUR AVE, SUITE 100, MUNDELEIN, IL 60060-2300
(847) 949-4104
(847) 949-4116
Mailing address
281 N SEYMOUR AVE, SUITE 100, MUNDELEIN, IL 60060-2300
(847) 949-4104
(847) 949-4116
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011246
IL
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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