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General NPI Number Information
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NPI Number | 1043500184
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Entity Type | Organization
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Legal Business Name | DEVINE HOME CARE
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 8428 9TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35206-4003
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Country | US
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Telephone | 205-777-1634
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Fax |
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Provider Business Mailing Address
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Address Line | 8428 9TH AVENUE SOUTH
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City | BIRMINGHAM
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State | AL
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Zip | 35206
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Country | US
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Telephone | 205-777-1634
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAKECIA L CARPENTER
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Credential |
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Telephone | 205-777-1634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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