Divine Home Care Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE HOME CARE SERVICES

Practice address

4351 Inlet Dr
Stockton, CA 95219-4992

Phone

(708) 832-3000

Fax

(708) 321-8219

NPI assigned

Jul 17, 2024

Organization subpart

No

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

Authorized official

Name

Addie Olaniyan

Title

Agency Manager

Phone

(708) 832-3000

Specialties & licenses 1

Addresses

Tax ID family

Divine Home Care Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Divine Home Care Services

  • In Home Supportive Care Agency
  • Stockton, CA
  • NPI 1720817067
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Addie Sunmbo Smith, RN

  • Registered Nurse
  • South Holland, IL
  • NPI 1922520683
  NPD

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1891533477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 RING RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095459",
            "telephone_number": "708-321-8218",
            "fax_number": "708-321-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 INLET DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952194992",
            "telephone_number": "708-832-3000",
            "fax_number": "708-321-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "OLANIYAN",
        "authorized_official_first_name": "ADDIE",
        "authorized_official_title_or_position": "AGENCY MANAGER",
        "authorized_official_telephone_number": "708-832-3000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Casuco Dipad
• Maria Trinidad Distancia
• Divine Caregivers
• Divine Covenant Care
• Divine Home Care Services
• Divinity Properties LLC
• Rosemary Dixon-Brown
• Christopher R. Dixon, MD
• Diamond Dixon
• Isabelle Marie Dixon, PA

• Home Health Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.