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Organization
EXCELCARE BY DIVINEE LLC
Active
Organization
EXCELCARE BY DIVINEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DIANE ROSE BROWN RN (PRESIDENT)
(770) 443-2273
Entity
Organization
Contact information
Practice address
284 SOMERSBY DR, DALLAS, GA 30157-8086
(770) 443-2273
(888) 883-4103
Mailing address
284 SOMERSBY DR, DALLAS, GA 30157-8086
(770) 443-2273
(888) 883-4103
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
110-R-0953
GA
253Z00000X
In Home Supportive Care Agency
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
3140N1450X
Pediatric Skilled Nursing Facility
110-R-0953
GA
Other
Enumeration date
03/03/2014
Last updated
08/11/2021
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