National Provider Identifier Database

DIVINE INTERVENTION HEALTHCARE INC
Hospice Care, Community Based


Contact Information

DIVINE INTERVENTION HEALTHCARE, INC
4747 LINCOLN MALL DR
SUITE 502
MATTESON, IL60443-3811
Phone: 708-248-7662
Fax: 708-248-7682
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for DIVINE INTERVENTION HEALTHCARE, INC

NPI Number 1427302041
Legal business name
LBN
DIVINE INTERVENTION HEALTHCARE, INC
Authorized official SANDRENA HARRIS - (DIRECTOR OF NURSING)
Entity Organization
Organization subpart No
Enumeration date 11/05/2012
Last updated 11/05/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 2003090

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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