Organization
DIVINE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FENTEZIA ZEWDIE RN (OWNER)
(612) 423-9765
Entity
Organization
Contact information
Practice address
16125 HYLAND AVE, LAKEVILLE, MN 55044-8883
(612) 423-9765
(952) 236-9202
Mailing address
16125 HYLAND AVE, LAKEVILLE, MN 55044-8883
(612) 423-9765
(952) 236-9202
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
376844
MN
251J00000X
Nursing Care Agency
376844
MN
Other
Enumeration date
04/07/2010
Last updated
01/05/2017
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