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General NPI Number Information
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NPI Number | 1942536107
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Entity Type | Organization
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Legal Business Name | DIVINE GRACE STAFFING SERVICES
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 18477 STONE HOLLOW DR SUITE 500
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City | GERMANTOWN
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State | MD
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Zip | 20874-2130
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Country | US
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Telephone | 240-421-7392
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Fax | 240-454-7485
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Provider Business Mailing Address
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Address Line | 18477 STONE HOLLOW DR SUITE 500
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City | GERMANTOWN
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State | MD
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Zip | 20874-2130
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Country | US
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Telephone | 240-421-7392
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Fax | 240-454-7485
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ADENIKE HANNAH AJIBADE
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Credential |
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Telephone | 240-421-7392
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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 | 0909006
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License Number State | MD
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