Organization
LORENZO SHEWAGN DIVINE GRAINGER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENZO GRAINGER (OWNER)
(980) 432-2376
Entity
Organization
Contact information
Practice address
11020 DAVID TAYLOR DR, CHARLOTTE, NC 28262-1101
(980) 432-2376
Mailing address
11020 DAVID TAYLOR DR, CHARLOTTE, NC 28262-1101
(980) 432-2376
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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