Organization
DIVINE HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAK RAHMAN MBBS,CPC,CPC-H (MANAGER)
(732) 567-7797
Entity
Organization
Contact information
Practice address
71 ANNAPOLIS ST, TINTON FALLS, NJ 07712-3175
(732) 567-7797
(888) 685-8722
Mailing address
71 ANNAPOLIS ST, TINTON FALLS, NJ 07712-3175
(732) 567-7797
(888) 685-8722
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
NJ
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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