| Organization Name: | DIVINE HEALTHCARE LLC |
| NPI Number: | 1003150475 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NAKIA CASSELL BENNETT (OWNER) |
| Mailing Address: | 3840 Middle Rd Edwards |
| State: | MS US |
| Postal Code: | 390669691 |
| Phone Number: | 6018962449 |
| Fax Number: | |
| NPI Enumeration Date: | 11/24/2012 |
| NPI Last Update Date: | 11/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251J00000X |
| License Number: | P318307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Nursing Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |