Organization
GLORY DIVINE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEDDRA WILLIAMS HOLMES LPN (CEO)
(985) 369-4111
Entity
Organization
Contact information
Practice address
4589-A HWY 1, NAPOLEONVILLE, LA 70390
(985) 369-4111
(985) 369-4110
Mailing address
P.O. BOX 867, 4589-A HWY 1, NAPOLEONVILLE, LA 70390
(985) 369-4111
(985) 369-4110
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1348961
LA
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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