Organization
DIVINE HOME HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAN S. KIM (ADMINISTRATOR)
(562) 407-0288
Entity
Organization
Contact information
Practice address
14241 FIRESTONE BLVD STE 235, LA MIRADA, CA 90638-5521
(562) 407-0288
(562) 407-0290
Mailing address
14241 FIRESTONE BLVD STE 235, LA MIRADA, CA 90638-5521
(562) 407-0288
(562) 407-0290
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
980001120
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08330F
—
CA
Enumeration date
08/04/2006
Last updated
04/04/2025
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