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General NPI Number Information
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NPI Number | 1265396774
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Entity Type | Organization
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Legal Business Name | DIVINE LOVE ADULT CARE LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 28860 SOUTHFIELD RD STE 202
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2726
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Country | US
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Telephone | 248-483-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 28860 SOUTHFIELD RD STE 202
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2726
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Country | US
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Telephone | 248-483-1130
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Fax | 248-483-1130
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ERICKA SHANAE WILLIAMS
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Credential | LPN
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Telephone | 248-483-1130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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