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General NPI Number Information
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NPI Number | 1265054290
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Entity Type | Organization
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Legal Business Name | DEVINE HOME AND HEALTH,LLC
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 5801 SW 19TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-5918
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Country | US
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Telephone | 754-214-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 SW 19TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-5918
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Country | US
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Telephone | 754-214-1510
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GINGER DEVINE
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Credential | OT
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Telephone | 954-451-1844
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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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