Organization
OM DIVINE HAVEN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EULALIA MARIA JIMENEZ-HINCAPIE (OWNER)
(305) 970-8671
Entity
Organization
Contact information
Practice address
8772 SW 212TH TER, CUTLER BAY, FL 33189-3879
(305) 970-8671
Mailing address
8772 SW 212TH TER, CUTLER BAY, FL 33189-3879
(305) 970-8671
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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