NPIMap

Organization Active NPI

Divine Healthcare Corporation

Doing business as Divine Healthcare Network

  • Home Health Agency
  • Saint Paul, MN
National Provider Identifier
1326150343
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
205335700 Issued in MN
Legal business name
DIVINE HEALTHCARE CORPORATION
Doing business as
Divine Healthcare Network
Practice address
856 University Ave W
Saint Paul, MN 55104-4807
Phone
(651) 665-9795
Fax
(651) 665-9796
NPI assigned
Aug 31, 2006
Last updated
Dec 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth Chinwe ObiNPI 1760867444
Title
Administrator/Ceo/Don
Phone
(651) 665-9795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 205335700 MN Primary

Addresses

Primary practice location

856 University Ave W
Saint Paul, MN 55104-4807

Mailing address

856 University Ave W
Saint Paul, MN 55104-4807
Phone (651) 665-9795

Other identifiers 7

IdentifierTypeStateIssuer
181647OtherMNU CARE MINNESOTA
5900021OtherMNMEDICA
1Z68UNOtherMNBLUE CROSS BLUE SHIELD
922134016OtherMNMHP: MINNESOTA HEALTH PLA
167251OtherMNUCARE
65531OtherMNHEALTH PARTNERS
1326150343MedicaidMN

Other names 1

  • DIVINE HEALTHCARE NETWORK Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120515000466 MN Part A Provider - Home Health Agency 8820258932 Practice locations: Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326150343. Details of each certification follow.

Home health agency certification: CCN 248055

Legal name
DIVINE HEALTHCARE CORPORATION
Doing business as
DIVINE HEALTHCARE NETWORK
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 28, 1997
Last certification
Nov 15, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 1, 1993 in MN
Enrollment address
856 University Ave W
Saint Paul, MN 55104-4807

Care Compare: Home health agency

Medicare Care Compare
Listed as
Divine Healthcare NetworkCCN 248055 · All quality measures
Ownership
Proprietary
Certified
Feb 28, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0931840Divine Healthcare Network856 University Avenue, Saint Paul, MN 55104Certificate of waiverAug 5, 2027

National Provider Directory

National Provider Directory

Locations

856 University Ave W
Saint Paul, MN 55104
Phone (651) 665-9795

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Chinwe Akuanata Elizabeth Obi-Walker Individual Corporate OfficerAssistant Administrator & Adon Jun 17, 2024
W-2 Managing EmployeeRegistered Nurse Mar 1, 2012
Operational/Managerial ControlAssistant Director of Nursing Oct 14, 2015
Elizabeth C Obi Individual 5% Or Greater Direct Ownership Interest Jun 17, 2024 100%
Corporate Officer Jun 17, 2024
W-2 Managing EmployeeAd;Ceo & Director of Nursing Jun 17, 2024
Operational/Managerial ControlAdministrator/Ceo/Don Jun 17, 2024
Okezie Irvin Obi Individual Corporate OfficerChief Finance Officer Oct 30, 2015
W-2 Managing EmployeeChief Finance Officer Oct 30, 2015
Operational/Managerial ControlChief Finance Officer Oct 30, 2015

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1326150343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044807",
            "telephone_number": "651-665-9795",
            "fax_number": "651-665-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044807",
            "telephone_number": "651-665-9795",
            "fax_number": "651-665-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "OBI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "CHINWE",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO/DON",
        "authorized_official_telephone_number": "651-665-9795"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "205335700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE MINNESOTA",
            "identifier": "181647",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5900021",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1Z68UN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHP: MINNESOTA HEALTH PLA",
            "identifier": "922134016",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "167251",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "65531",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326150343",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIVINE HEALTHCARE NETWORK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.