Organization
DEBRA'S DIVINE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA ANN WALLACE (CEO/ OWNER)
(813) 546-4884
Entity
Organization
Contact information
Practice address
5608 KENNY DR, TAMPA, FL 33617-7711
(813) 546-4884
(813) 983-1860
Mailing address
5608 KENNY DR, TAMPA, FL 33617-7711
(813) 546-4884
(813) 983-1860
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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