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General NPI Number Information
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NPI Number | 1700081841
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Entity Type | Organization
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Legal Business Name | DEVINE NURSING SERVICES LLC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3222 STUART LN
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City | DEARBORN
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State | MI
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Zip | 48120-1359
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Country | US
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Telephone | 248-416-6352
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 STUART LN
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City | DEARBORN
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State | MI
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Zip | 48120-1359
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Country | US
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Telephone | 248-416-6352
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Fax |
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MS. FLORA LOUISE COUSINS
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Credential | RN
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Telephone | 248-416-6352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | MI
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