Organization
LIVING DIVINE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOANIA WILKS-DEVINE (OWNER / PRESIDENT)
(215) 866-8177
Entity
Organization
Contact information
Practice address
2455 W SERGEANT ST, PHILADELPHIA, PA 19132-4135
(215) 399-2788
Mailing address
2455 W SERGEANT ST, PHILADELPHIA, PA 19132-4135
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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