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Organization

DIVINE HOMECARE LLC

Active
Parent organization
DIVINE HOMECARE LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DIVINE HOMECARE LLC
Authorized official
MRS. FLORINE L FLEMING (OWNER/SERVICE DIRECTOR)
(910) 904-2377
Entity
Organization

Contact information

Practice address
5511 RAEFORD RD, FAYETTEVILLE, NC 28304-2057
(910) 429-7481
(910) 429-7480
Mailing address
751 S MAIN ST, SUITE B, RAEFORD, NC 28376-3258
(910) 904-2377
(910) 904-2477

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3012
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6601209
NC
Enumeration date
05/06/2009
Last updated
05/06/2009
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