Organization
DIVINEFAVOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA UBAKA (MANAGER)
(757) 966-0410
Entity
Organization
Contact information
Practice address
1014 LEVEL GREEN BLVD, VIRGINIA BEACH, VA 23464
(757) 214-5205
Mailing address
1014 LEVEL GREEN BLVD, VIRGINIA BEACH, VA 23464-4509
(757) 214-5205
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
2016-269673-R
VA
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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