Organization
DIVINE CASE MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY K CALDWELL ADMINISTRATOR (ADMINISTRATOR)
(318) 938-5375
Entity
Organization
Contact information
Practice address
7530 GREENWOOD ROAD, SHREVEPORT, LA 71119
(318) 938-5375
(318) 938-5376
Mailing address
7530 GREENWOOD ROAD, SHREVEPORT, LA 71047
(318) 938-5375
(318) 938-5376
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CM 27002
LA
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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