Organization
DIVINE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHARLENE RICHARDSON (OWNER)
(167) 843-8529
Entity
Organization
Contact information
Practice address
2421 WEVOK WAY, GRAYSON, GA 30017-4340
(167) 843-8529
Mailing address
2421 WEVOK WAY, GRAYSON, GA 30017-4340
(167) 843-8529
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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