Organization
DIVINE CARE SOURCE INC
Active
Other names
DCS
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL ROBERSON MSW (PRESIDENT)
(478) 305-3019
Entity
Organization
Contact information
Practice address
31055 PARROT REEF CT, WESLEY CHAPEL, FL 33545-5149
(478) 305-3019
Mailing address
31055 PARROT REEF CT, WESLEY CHAPEL, FL 33545-5149
(478) 305-3019
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311ZA0620X
Adult Care Home Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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