Organization
DIVINE HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKO L MATTHEWS (CHEIF EXECUTIVE OFFICER)
(910) 670-5458
Entity
Organization
Contact information
Practice address
4244 CUMBERLAND RD, FAYETTEVILLE, NC 28306-2697
(910) 491-1002
Mailing address
1610 SHIVELY CT, FAYETTEVILLE, NC 28304-4034
(910) 670-5458
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
06/06/2025
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