Healthcare Provider Details

I. General information

NPI: 1225439789
Provider Name (Legal Business Name): DIVINE QUALITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 DOUGLAS AVE UNIT B
NASHVILLE TN
37206-2308
US

IV. Provider business mailing address

1515 DOUGLAS AVE UNIT B
NASHVILLE TN
37206-2308
US

V. Phone/Fax

Practice location:
  • Phone: 615-830-0795
  • Fax:
Mailing address:
  • Phone: 615-830-0795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateTN

VIII. Authorized Official

Name: NATASHA STEWART
Title or Position: OWNER
Credential:
Phone: 615-830-0795