Organization
1 GALAXY OF DIVINE HOMECARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER BASSEY-BLACK (ODS)
(763) 390-2586
Entity
Organization
Contact information
Practice address
13570 GROVE DR, STE #211, MAPLE GROVE, MN 55311-4400
(763) 390-2586
Mailing address
13570 GROVE DR, STE #211, MAPLE GROVE, MN 55311-4400
(763) 390-2586
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/24/2010
Last updated
10/24/2010
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