Organization
DIVINE ROYAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR O. WAGIDI (EXECUTIVE DIRECTOR)
(303) 695-6684
Entity
Organization
Contact information
Practice address
10730 E BETHANY DR STE 185, AURORA, CO 80014-2690
(303) 695-6684
(303) 856-3389
Mailing address
10730 E BETHANY DR STE 185, AURORA, CO 80014-2690
(303) 695-6684
(303) 856-3389
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
14689740
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14689740
—
CO
Enumeration date
04/03/2016
Last updated
04/03/2016
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