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General NPI Number Information
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NPI Number | 1841922119
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Entity Type | Organization
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Legal Business Name | DIVINE CARE NETWORKS
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 07/04/2022
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Provider Practice Location Address
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Address Line | 2210 LYNETTE DR
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City | GREENSBORO
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State | NC
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Zip | 27403-3717
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Country | US
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Telephone | 252-903-0504
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 LYNETTE DR
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City | GREENSBORO
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State | NC
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Zip | 27403-3717
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Country | US
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Telephone | 252-903-0504
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LASHUNDA LYNCH PERRY
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Credential |
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Telephone | 252-903-0504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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