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Organization
DIVINE PRIVATE HOME CARE PROVIDER
Active
Organization
DIVINE PRIVATE HOME CARE PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LATIFAT ABIMBOLA OKE BACHELOR IN NURSING (ADMINISTRATOR)
(678) 517-5305
Entity
Organization
Contact information
Practice address
7317 DEXTER DR, RIVERDALE, GA 30296-1522
(678) 517-5305
Mailing address
7317 DEXTER DR, RIVERDALE, GA 30296-1522
(678) 517-5305
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
031-R-1124
GA
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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