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General NPI Number Information
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NPI Number | 1477732733
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Entity Type | Organization
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Legal Business Name | DIVINE CARE SERVICES, INC.
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 5190 NW 167TH ST SUITE 211
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-430-9520
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Fax | 305-430-9521
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Provider Business Mailing Address
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Address Line | 5190 NW 167TH ST SUITE 211
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-430-9520
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Fax | 305-430-9521
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Authorized Official
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Title or Position | OWNER/CFO
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Name | MR. ISHTIAQ JINNAH
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Credential |
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Telephone | 305-430-9520
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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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