Provider Demographics
NPI:1548615065
Name:DIVINE HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:DIVINE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GATOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-860-1072
Mailing Address - Street 1:1577B GOODMAN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1004
Mailing Address - Country:US
Mailing Address - Phone:513-860-1072
Mailing Address - Fax:513-297-9292
Practice Address - Street 1:1577B GOODMAN AVE STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1004
Practice Address - Country:US
Practice Address - Phone:513-860-1072
Practice Address - Fax:513-297-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health