OrganizationActive
Divine Healthcare Services
NPI 1982999090 · Nursing Facility/Intermediate Care Facility · Brown Deer, WI
Provider details
- NPI number
- 1982999090
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Gold Omereonye, Owner
- License
- 126208-30 (WI)
Practice location
4238 W Hawthorne Trace Rd Apt 104
Brown Deer, WI 53209-1026
Phone: (414) 975-0121
Mailing address
4238 W Hawthorne Trace Rd Apt 104
Brown Deer, WI 53209-1026
Registry dates
- Enumerated
- 2011-06-16
- Last updated
- 2011-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.