Organization
CHAS VAN DIVIERE LTD
Active
Parent organization
CHAS VAN DIVIERE LTD
Other names
Diveres Home Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHAS VAN DIVIERE LTD
Authorized official
MR. CHAS L VAN DIVIERE JR. (PRES)
(706) 285-2073
Entity
Organization
Contact information
Practice address
357 BOYCE GUIN RD, TIGNALL, GA 30668
(706) 285-2073
(706) 285-2076
Mailing address
357 BOYCE GUIN RD, TIGNALL, GA 30668
(706) 285-2073
(706) 285-2076
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00530406A
—
GA
Enumeration date
12/29/2006
Last updated
07/23/2008
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