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Organization
DIVINE INTERVENTION HOME CARE
Active
Organization
DIVINE INTERVENTION HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRALVIS SHAW (CEO)
(336) 267-4517
Entity
Organization
Contact information
Practice address
2155 WOW RD, RANDLEMAN, NC 27317-7951
(336) 267-4517
Mailing address
2155 WOW RD, RANDLEMAN, NC 27317-7951
(336) 653-7916
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
01/28/2020
Last updated
10/10/2022
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