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DIVINE HEALTHCARE SERVICES
NPI 1982999090
Nursing Facility/Intermediate Care Facility in Brown Deer, WI

Active since June 16, 2011
4238 W HAWTHORNE TRACE RD APT 104, BROWN DEER, WI 53209(414) 975-0121 Get Directions Write a Review

NPPES record last updated: June 16, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Divine Healthcare Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINE HEALTHCARE SERVICES (NPI 1982999090) is a healthcare organization registered as a nursing facility/intermediate care facility in Brown Deer, Wisconsin and active in the NPI registry since June 2011. The organization lists Gold Omereonye, Owner, as its authorized official.

NPPES Registry Identity

NPI1982999090
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameDIVINE HEALTHCARE SERVICES
Location Address4238 W HAWTHORNE TRACE RD APT 104Brown Deer, WI 53209-1026
Mailing Address4238 W Hawthorne Trace Rd Apt 104Brown Deer, WI 53209-1026
Phone(414) 975-0121
Organization SubpartNo
Authorized OfficialGold OmereonyeOwner · (414) 975-0121
Enumeration DateJune 16, 2011
✔ NPI 1982999090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in WI · 126208-30
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
4238 W HAWTHORNE TRACE RD APT 104, Brown Deer, WI 53209
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Other Identifiers 1

Other271904077TX · Irs

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GOLD A OMEREONYE RN
Registered Nurse
4238 W HAWTHORNE TRACE RD APT 104, #104
BROWN DEER, WI 53209
Milwaukee County (414) 975-0121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divine Healthcare Services's NPI number?

The NPI number for Divine Healthcare Services is 1982999090. It was assigned to this organization in the NPPES registry on June 16, 2011.

Where is Divine Healthcare Services located?

Divine Healthcare Services is located at 4238 W Hawthorne Trace Rd Apt 104, Brown Deer, WI 53209. The listed phone number is (414) 975-0121.

What is Divine Healthcare Services's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Divine Healthcare Services was last updated on June 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.