Organization
DIVINE SUPREME HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENSON FAYEMI (PRESIDENT)
(973) 704-1838
Entity
Organization
Contact information
Practice address
1039 WALNUT LN, LANSDALE, PA 19446-4505
(973) 704-1838
Mailing address
1039 WALNUT LN, LANSDALE, PA 19446-4505
(973) 704-1838
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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