Organization
DIVINE 4 SUPPORT LLC
Active
Organization
DIVINE 4 SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE BOYD (OWNER)
(313) 477-9642
Entity
Organization
Contact information
Practice address
15378 VERONICA AVE, EASTPOINTE, MI 48021-3636
(313) 477-9642
(313) 521-3767
Mailing address
15378 VERONICA AVE, EASTPOINTE, MI 48021-3636
(313) 477-9642
(313) 521-3767
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251E00000X
Home Health Agency
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376G00000X
Nursing Home Administrator
—
—
Other
Enumeration date
11/06/2023
Last updated
01/10/2025
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