# DIVINE PRIVATE HOME CARE PROVIDER

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

## Provider details

- **NPI number:** 1932599610
- **Authorized official:** MISS LATIFAT ABIMBOLA OKE BACHELOR IN NURSING (ADMINISTRATOR)
- **Authorized official phone:** (678) 517-5305

## Contact information

- **Practice address:** 7317 DEXTER DR, RIVERDALE, GA 30296-1522
- **Practice address phone:** (678) 517-5305
- **Mailing address:** 7317 DEXTER DR, RIVERDALE, GA 30296-1522
- **Mailing address phone:** (678) 517-5305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 031-R-1124 | GA | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 02/02/2015