Organization
DIVINE CARE 1962
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SHANKS (OWNER)
(706) 798-2289
Entity
Organization
Contact information
Practice address
1962 NEPTUNE DR, AUGUSTA, GA 30906-5703
(706) 798-2289
(706) 792-6228
Mailing address
1962 NEPTUNE DR, AUGUSTA, GA 30906-5703
(706) 798-2289
(706) 792-6228
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
121-01-459-1
GA
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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