Organization
DIVINE HEALING SENIOR & DISABLED SERVICES LLC
Active
Other names
Decorkus V Allen
Organization subpart
No
Provider details
NPI number
Authorized official
DECORKUS ALLEN (CEO)
(850) 274-7104
Entity
Organization
Contact information
Practice address
8866 HIGH BRIDGE RD, MIDWAY, FL 32343
(850) 274-7104
Mailing address
211 GAY ST, HAVANA, FL 32333-1646
(850) 274-7104
(239) 785-1707
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021500500
—
FL
05
—
114242100
—
FL
Enumeration date
05/05/2020
Last updated
06/22/2023
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