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General NPI Number Information
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NPI Number | 1487440434
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Entity Type | Organization
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Legal Business Name | DIVINE LOVE HOMECARE LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 351 SHERMAN AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511-3107
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Country | US
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Telephone | 860-503-6825
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Fax |
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Provider Business Mailing Address
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Address Line | 415 BOSTON POST RD STE 3
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City | MILFORD
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State | CT
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Zip | 06460-2578
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Country | US
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Telephone | 203-606-8910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOMONIQUE BOWEN
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Credential |
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Telephone | 203-606-8910
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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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