Divine Private Home Care Provider

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

031-R-1124 Issued in GA

Legal business name

DIVINE PRIVATE HOME CARE PROVIDER

Practice address

7317 Dexter Dr
Riverdale, GA 30296-1522

Phone

(678) 517-5305

NPI assigned

Feb 2, 2015

Last updated

Feb 2, 2015By 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

Miss Latifat Abimbola Oke, BACHELOR IN NURSING

Title

Administrator

Phone

(678) 517-5305

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1932599610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7317 DEXTER DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961522",
            "telephone_number": "678-517-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7317 DEXTER DR",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302961522",
            "telephone_number": "678-517-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PRIVATE HOME CARE PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "OKE",
        "authorized_official_first_name": "LATIFAT",
        "authorized_official_middle_name": "ABIMBOLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-517-5305",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BACHELOR IN NURSING"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "031-R-1124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eloy Edilberto Diaz Sr., M.D.
• Terry Dickerson, D.P.M.
• Michael Angel Dicristina, M.D.
• Dignity Hospice and Healthcare LLC
• Divine Healing Healthcare & Durable Medical Equipment LLC
• Divine Source Healthcare Systems, Inc
• Divine Trinity Mobile Lab & CPR Services, LLC
• Barry R Dix, M.S.
• Fredrico Albert Dixon III, DDS
• DME of Georgia, Inc

• Home Health Agency in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.