Divine Health Care Services, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

02940501 Issued in PA

Legal business name

DIVINE HEALTH CARE SERVICES, INC

Practice address

6800 Castor Ave
Suite D
Philadelphia, PA 19149-2106

Phone

(215) 745-8492

Fax

(215) 745-8482

NPI assigned

Jul 27, 2007

Last updated

Jul 27, 2007By 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

Mrs. Norene A Essien-Etokimoh, RN

Title

Admistrator/DPS

Phone

(215) 745-8492

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790975571. Details of each certification follow.

• CCN 398080 Home health agency · Active · Details

Home health agency certification: CCN 398080

Legal name

DIVINE HEALTH CARE SERVICES, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 16, 2008

Last certification

Oct 25, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 23, 2006 in PA

Enrollment address

6800 Castor Ave
Ste B
Philadelphia, PA 19149-2100

Listed as

Divine Health Care ServicesCCN 398080 · All quality measures

Ownership

Proprietary

Certified

May 16, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

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.

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.

• Noel Okon

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
  • NPI 1467285346
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1790975571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 CASTOR AVE",
            "address_2": "SUITE D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492106",
            "telephone_number": "215-745-8492",
            "fax_number": "215-745-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 CASTOR AVE",
            "address_2": "SUITE D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492106",
            "telephone_number": "215-745-8492",
            "fax_number": "215-745-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "ESSIEN-ETOKIMOH",
        "authorized_official_first_name": "NORENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMISTRATOR/DPS",
        "authorized_official_telephone_number": "215-745-8492",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "02940501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Comfort Home Health LLC
• Divine Connections Agency LLC
• Divine Connections Home Care Agency (None)
• Divine Gifted Hands Home Care LLC.
• Divine Hands of Destiny Home Care
• Divine Health Home Care Services,Inc
• Divine Light Inc
• Divine Mercy Home Care, LLC
• Divine Nursing Care LLC
• Divine Path Home Care LLC

• Home Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.