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Organization

DIVINE LIVING LIMITED LIABILITY COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. VICTOR EGBIREMOLEN (OWNER/ASSISTED LIVING MANAGER)
(443) 682-3762
Entity
Organization

Contact information

Practice address
202 E LANVALE ST, BALTIMORE, MD 21202-2814
(443) 682-3762
Mailing address
8620 PLEASANT PLAINS RD, TOWSON, MD 21286-2351
(443) 682-3762

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
12/14/2020
Last updated
12/14/2020
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