Organization
DIVINE HOME HEALTH CARE II, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GELYS GONGORA (ADMINISTRATOR)
(813) 810-8650
Entity
Organization
Contact information
Practice address
3501 W VINE ST, KISSIMMEE, FL 34741-4643
(813) 810-8650
Mailing address
3501 W VINE ST, KISSIMMEE, FL 34741-4643
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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