Divine Home Health Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE HOME HEALTH SERVICES INC

Practice address

9245 Calumet Ave
Ste 107
Munster, IN 46321-2821

Phone

(773) 829-1348

NPI assigned

Jan 5, 2016

Last updated

Jan 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mutiat KuforijiNPI 1790445708

Title

Owner

Phone

(773) 829-1348

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396101424. Details of each certification follow.

• CCN 157696 Home health agency · Active · Details

Home health agency certification: CCN 157696

Legal name

DIVINE HOME HEALTH SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 31, 2017

Last certification

Aug 31, 2017

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

9245 Calumet Ave
Ste 106
Munster, IN 46321-4172

Listed as

Divine Home Health Services IncCCN 157696 · All quality measures

Ownership

Proprietary

Certified

Aug 31, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

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

Practitioners 1

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.

• Mutiat Kuforiji

  • Registered Nurse
  • Matteson, IL
  • NPI 1790445708
  NPD Authorized official

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jose Luis Agusti, M.D.

  • Internal Medicine Physician
  • Winfield, IN
  • NPI 1033192604

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1396101424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 CALUMET AVE",
            "address_2": "STE 107",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212821",
            "telephone_number": "773-829-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 CALUMET AVE",
            "address_2": "STE 107",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212821",
            "telephone_number": "773-829-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "KUFORIJI",
        "authorized_official_first_name": "MUTIAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-829-1348"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Dinatale, PHARM D
• Diane Dinino, PT
• Jillian Ditusa, PA-C
• Anuradha Divakaruni, M.D.
• Shashidhar Divakaruni, M.D.
• Nikola Djorovic, D.D.S.
• Maryanhthu DO, D.O.
• Danielle Renee Dobkowski
• Marris Taylor Dobosz, RN
• Erica Dockens, LCSW, RN

• Home Health Agency in Munster, IN
• Providers in Munster, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.