Organization
J&T DIVINE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TESICA BARNES (ADMINISTRATOR)
(407) 756-9982
Entity
Organization
Contact information
Practice address
440 ROYELLOU LN STE 205, MOUNT DORA, FL 32757-5520
(407) 756-9492
Mailing address
440 ROYELLOU LN STE 205, MOUNT DORA, FL 32757-5520
(407) 756-9492
(352) 729-2210
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109695900
—
FL
Enumeration date
02/24/2022
Last updated
03/20/2022
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