Active NPI
Divine Healthcare Services
- Home Health Agency
- East Orange, NJ
National Provider Identifier
1396303384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- DIVINE HEALTHCARE SERVICES
- Doing business as
- Divine Healthcare Services
- Practice address
- 60 Evergreen PL Ste 501
East Orange, NJ 07018-2118 - Phone
- (973) 395-9501
- Fax
- (973) 395-9502
- NPI assigned
- Jun 4, 2019
- Last updated
- Jun 4, 2019
- Organization subpart
- Yes
- Parent organization
- DIVINE HEALTHCARE SERVICES
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stella Obodigbo
- Title
- Director of Nursing
- Phone
- (973) 395-9501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
60 Evergreen PL Ste 501
East Orange, NJ 07018-2118
Mailing address
60 Evergreen PL Ste 501
East Orange, NJ 07018-2118
Phone (973) 395-9501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0254967 | Medicaid | NJ |
Other names 1
- DIVINE HEALTHCARE SERVICES
National Provider Directory
National Provider Directory- Tax ID family
- Divine Healthcare Services
- Part of
- Divine Healthcare Services
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- East Orange, NJ
- NPI 1952840415
-
- Home Health Agency
- East Orange, NJ
- NPI 1225290430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1559606400000",
"number": "1396303384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 EVERGREEN PL STE 501",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070182118",
"telephone_number": "973-395-9501",
"fax_number": "973-395-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 EVERGREEN PL STE 501",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070182118",
"telephone_number": "973-395-9501",
"fax_number": "973-395-9502"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DIVINE HEALTHCARE SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DIVINE HEALTHCARE SERVICES",
"enumeration_date": "2019-06-04",
"last_updated": "2019-06-04",
"status": "A",
"authorized_official_last_name": "OBODIGBO",
"authorized_official_first_name": "STELLA",
"authorized_official_title_or_position": "DIRECTOR OF NURSING",
"authorized_official_telephone_number": "973-395-9501"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0254967",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DIVINE HEALTHCARE SERVICES",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.