Healthcare Provider Details
I. General information
NPI: 1124656293
Provider Name (Legal Business Name): DIVINE TOUCH HOME HELP SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
420 AVENUE G
BIRMINGHAM AL
35214-5432
US
IV. Provider business mailing address
PO BOX 311315
BIRMINGHAM AL
35231-1315
US
V. Phone/Fax
- Phone: 205-791-7927
- Fax:
- Phone: 205-791-7927
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CARLA
LA TRESE
STEVENSON
Title or Position: OWNER
Credential:
Phone: 205-791-7927