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General NPI Number Information
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NPI Number | 1336885516
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Entity Type | Organization
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Legal Business Name | DYVINE CARING AIDEZ LLC
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 835 CENTRAL AVE STE 410
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City | HOT SPRINGS
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State | AR
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Zip | 71901-5351
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Country | US
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Telephone | 501-701-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 835 CENTRAL AVE STE 410
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City | HOT SPRINGS
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State | AR
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Zip | 71901-5351
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Country | US
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Telephone | 501-701-4239
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | LUEVERSIE GORDEN
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Credential |
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Telephone | 501-617-6269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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