Organization
EL & DIVINE HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIDA A ADUSEI-POKU (ADMINISTRATOR/ OWNER)
(703) 987-5052
Entity
Organization
Contact information
Practice address
3330 BOURBON ST STE 108, FREDERICKSBURG, VA 22408-7333
(540) 689-0333
(540) 689-0333
Mailing address
3330 BOURBON ST STE 108, FREDERICKSBURG, VA 22408-7333
(540) 689-0333
(540) 689-0333
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-151153
VA
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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