Provider Demographics
NPI:1043500184
Name:DEVINE HOME CARE
Entity type:Organization
Organization Name:DEVINE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAKECIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-777-1634
Mailing Address - Street 1:8428 9TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35206
Mailing Address - Country:US
Mailing Address - Phone:205-777-1634
Mailing Address - Fax:
Practice Address - Street 1:8428 9TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-4003
Practice Address - Country:US
Practice Address - Phone:205-777-1634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health