MEDICARE: DIVINE TOUCH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1336523471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE TOUCH INC

Provider Business Mailing Address
First Line	:	1828 ARCH STONE AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-5095
Country	:	US
Telephone Number	:	702-787-2116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 ARCH STONE AVE
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89031-5095
Country	:	US
Telephone Number	:	702-787-2116
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHINEKA FOY
Credential	:
Telephone Number	:	702-754-3901

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	07/18/2015

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Directions to “DIVINE TOUCH INC ” Practice Location

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