Organization
DIVINE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS WELMA M YALARTAI (OWNER)
(469) 279-6119
Entity
Organization
Contact information
Practice address
1544 E GATEWAY CIR S APT 206, FARGO, ND 58103-3643
(469) 279-6119
Mailing address
3523 45TH ST S STE 155, FARGO, ND 58104-8962
(469) 279-6119
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477976
NON MEDICAL HOME CARE
ND
Enumeration date
10/13/2020
Last updated
10/13/2020
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