Organization
DIVINE CAREGIVERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN BOSS (OWNER)
(209) 483-3466
Entity
Organization
Contact information
Practice address
9920 WENDT WAY, STOCKTON, CA 95209-4523
(209) 483-3466
Mailing address
9920 WENDT WAY, STOCKTON, CA 95209-4523
(209) 483-3466
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
0900096452
CA
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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