Organization
DIVINE AFC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RATNA BALAGANI (MANAGER)
(508) 368-4358
Entity
Organization
Contact information
Practice address
716 W BOYLSTON ST STE 2, WORCESTER, MA 01606-3074
(508) 444-0955
Mailing address
716 W BOYLSTON ST STE 2, WORCESTER, MA 01606-3074
(508) 444-0955
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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