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General NPI Number Information
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NPI Number | 1760795215
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Entity Type | Organization
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Legal Business Name | DIVINE LIVING HOME CARE AGENCY,INC.
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 403 N. JK POWELL BLVD.
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City | WHITEVILLE
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State | NC
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Zip | 28472-7188
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Country | US
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Telephone | 910-641-4117
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Fax |
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Provider Business Mailing Address
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Address Line | 403 N JK POWELL BLVD
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City | WHITEVILLE
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State | NC
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Zip | 28472-3128
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Country | US
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Telephone | 910-625-9774
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LEANNA GRIFFIN
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Credential |
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Telephone | 910-625-9774
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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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