Organization
DIVINELY PURPOSED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRIS ANTON VICKERS II (OWNER/OPERATOR)
(407) 283-9855
Entity
Organization
Contact information
Practice address
255 S ORANGE AVE STE 104, ORLANDO, FL 32801-3411
(407) 283-9855
Mailing address
831 OAKLEY SEAVER DR APT 410, CLERMONT, FL 34711-1990
(407) 283-9855
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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