Organization
DIVINE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SWANSON (LICENSEE)
(909) 419-6741
Entity
Organization
Contact information
Practice address
25937 LAWTON AVE, LOMA LINDA, CA 92354-3838
(909) 419-6741
Mailing address
25937 LAWTON AVE, LOMA LINDA, CA 92354-3838
(909) 419-6741
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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