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Organization
DIVINE SENIOR HOME CARE LLC
Active
Organization
DIVINE SENIOR HOME CARE LLC
Active
Other names
Divine Senior Home Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BUSHRA CHAUDHARY (ADMINISTRATOR)
(703) 677-0506
Entity
Organization
Contact information
Practice address
17300 RIVER RIDGE BLVD STE 202A, WOODBRIDGE, VA 22191-5168
(703) 677-0506
Mailing address
17300 RIVER RIDGE BLVD STE 202A, WOODBRIDGE, VA 22191-5168
(703) 677-0506
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-1790
VA
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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