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Organization
GEORGIA'S DIVINE HOME CARE LLC
Active
Organization
GEORGIA'S DIVINE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATILDA SMITH (OWNER)
(901) 495-3857
Entity
Organization
Contact information
Practice address
2883 BASKIN ST, MEMPHIS, TN 38127-7705
(901) 495-3857
Mailing address
2883 BASKIN ST, MEMPHIS, TN 38127-7705
(901) 495-3857
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
NULL
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
385H00000X
Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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