# DEVINE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538418561
- **Authorized official:** MRS. TECONDA L. DOUGLAS ANP-BC (ADULT NURSE PRACTITIONER, OWNER)
- **Authorized official phone:** (314) 496-1858

## Contact information

- **Practice address:** 956 MOLLOY DR, O FALLON, MO 63366-3229
- **Practice address phone:** (314) 496-1858
- **Mailing address:** 956 MOLLOY DR, O FALLON, MO 63366-3229
- **Mailing address phone:** (314) 496-1858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/05/2012
- **Last updated:** 08/18/2014