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Organization

GEORGIA'S DIVINE HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATILDA SMITH (OWNER)
(901) 495-3857
Entity
Organization

Contact information

Practice address
2883 BASKIN ST, MEMPHIS, TN 38127-7705
(901) 495-3857
Mailing address
2883 BASKIN ST, MEMPHIS, TN 38127-7705
(901) 495-3857

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
372600000X
Adult Companion
Primary
385H00000X
Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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