Organization
DIVINECARELLC
Active
Other names
Divinecarellc
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA E ORIKANNU SIMON (OWNER)
(888) 994-9937
Entity
Organization
Contact information
Practice address
16926 SW STEELE WAY, BEAVERTON, OR 97006-8936
(971) 222-9122
Mailing address
16926 SW STEELE WAY, BEAVERTON, OR 97006-8936
(971) 222-9122
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
15-2330
OR
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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