Organization
DEVINE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TECONDA L. DOUGLAS ANP-BC (ADULT NURSE PRACTITIONER, OWNER)
(314) 496-1858
Entity
Organization
Contact information
Practice address
956 MOLLOY DR, O FALLON, MO 63366-3229
(314) 496-1858
Mailing address
956 MOLLOY DR, O FALLON, MO 63366-3229
(314) 496-1858
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/05/2012
Last updated
08/18/2014
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