Provider Demographics
NPI:1871466730
Name:DIVINE MERCY CARE AFH
Entity type:Organization
Organization Name:DIVINE MERCY CARE AFH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MILLION
Authorized Official - Middle Name:HAGOS
Authorized Official - Last Name:MILLION
Authorized Official - Suffix:
Authorized Official - Credentials:NC61464429
Authorized Official - Phone:206-771-8314
Mailing Address - Street 1:12620 86TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-7901
Mailing Address - Country:US
Mailing Address - Phone:206-330-5665
Mailing Address - Fax:253-387-5622
Practice Address - Street 1:12620 86TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-7901
Practice Address - Country:US
Practice Address - Phone:206-330-5665
Practice Address - Fax:253-387-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home