Organization
DIVINE INTERVENTION HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRENA ARMETTA HARRIS RN (DIRECTOR OF NURSING)
(708) 248-7662
Entity
Organization
Contact information
Practice address
4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
(708) 248-7662
(708) 248-7682
Mailing address
4747 LINCOLN MALL DR, SUITE 502, MATTESON, IL 60443-3811
(708) 248-7662
(708) 248-7682
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
Other
Enumeration date
06/19/2011
Last updated
10/30/2012
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