Organization
ITS IN THE DIVINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL DIXON (CEO)
(313) 205-4524
Entity
Organization
Contact information
Practice address
607 SHELBY ST STE 700-1117, DETROIT, MI 48226-3268
(313) 766-2020
(231) 216-7580
Mailing address
18115 LITTLEFIELD ST, DETROIT, MI 48235-1466
(313) 205-4524
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
802633631
—
MI
Enumeration date
10/04/2021
Last updated
10/04/2021
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