Organization
DIVINE HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRIETTA HENRIETTA (OWNER/ADMINISTRATOR)
(301) 916-6276
Entity
Organization
Contact information
Practice address
22430 GLENBOW WAY, CLARKSBURG, MD 20871-9482
(301) 916-6276
Mailing address
22430 GLENBOW WAY, CLARKSBURG, MD 20871-9482
(301) 916-6276
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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