Organization
DIVINE HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM BREDE NURSE (ADMINISTRATOR)
(320) 231-9757
Entity
Organization
Contact information
Practice address
322 2ND ST SW, WILLMAR, MN 56201
(320) 231-9757
(320) 231-9795
Mailing address
322 2ND ST SW, WILLMAR, MN 56201
(320) 231-9757
(320) 231-9795
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510606100
—
MN
Enumeration date
07/13/2006
Last updated
03/22/2019
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