Provider Demographics
NPI:1447130133
Name:DIVINE VISSION HOMECARE LLC
Entity type:Organization
Organization Name:DIVINE VISSION HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLAWAHE
Authorized Official - Middle Name:JOHU
Authorized Official - Last Name:OYARINU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-317-8103
Mailing Address - Street 1:40 KNOT STREET APT B3
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516
Mailing Address - Country:US
Mailing Address - Phone:203-317-8103
Mailing Address - Fax:
Practice Address - Street 1:40 KNOT STREET APT B3
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-317-8103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care