Provider Demographics
NPI:1871873984
Name:WILD KARMA, INC DBA DIVINE HOME CARE
Entity type:Organization
Organization Name:WILD KARMA, INC DBA DIVINE HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-639-9088
Mailing Address - Street 1:241 JOAQUIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4709
Mailing Address - Country:US
Mailing Address - Phone:510-639-9088
Mailing Address - Fax:510-639-1814
Practice Address - Street 1:241 JOAQUIN AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4709
Practice Address - Country:US
Practice Address - Phone:510-639-9088
Practice Address - Fax:510-639-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care