Provider Demographics
NPI:1174217871
Name:DEVINE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:DEVINE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-401-1538
Mailing Address - Street 1:3592 BROADWAY STE 130
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-8056
Mailing Address - Country:US
Mailing Address - Phone:727-401-1538
Mailing Address - Fax:
Practice Address - Street 1:3592 BROADWAY STE 130
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8056
Practice Address - Country:US
Practice Address - Phone:727-401-1538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health