Organization
DIVINE COMMUNITY HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELIQUE MARIA PORTER (PRESIDENT)
(614) 861-0861
Entity
Organization
Contact information
Practice address
7550 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-3156
(614) 861-0861
(614) 861-8026
Mailing address
7550 SLATE RIDGE BLVD, REYNOLDSBURG, OH 43068-3156
(614) 861-0861
(614) 861-8026
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2649227
—
OH
Enumeration date
09/24/2008
Last updated
09/24/2008
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