Organization
DAVORE HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSOLA ADERIBIGBE (PARTNER)
(718) 200-4219
Entity
Organization
Contact information
Practice address
1129 HOSPITAL DR STE 6F, STOCKBRIDGE, GA 30281-6393
(678) 835-3334
Mailing address
1129 HOSPITAL DR STE 6F, STOCKBRIDGE, GA 30281-6393
(678) 835-3334
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP011304
GEORGIA DEPARTMENT OF COMMUNITY HEALTH
GA
Enumeration date
11/17/2021
Last updated
11/17/2021
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