Healthcare Provider Details

I. General information

NPI: 1174138564
Provider Name (Legal Business Name): DIVINE ANGELS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4751 BEST RD # 398
COLLEGE PARK GA
30337-5615
US

IV. Provider business mailing address

4751 BEST RD # 398
COLLEGE PARK GA
30337-5615
US

V. Phone/Fax

Practice location:
  • Phone: 404-882-3136
  • Fax: 404-891-4862
Mailing address:
  • Phone: 404-882-3136
  • Fax: 404-891-4862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BADGETT
Title or Position: OWNER
Credential:
Phone: 470-916-6046