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
—
—
305R00000X
Preferred Provider Organization
—
ID
Other
Enumeration date
06/02/2014
Last updated
05/08/2019
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