Provider Demographics
NPI:1376995951
Name:DEVOTED DIVAS HOME CARE
Entity Type:Organization
Organization Name:DEVOTED DIVAS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-408-0042
Mailing Address - Street 1:1361 SMYRNA RD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8968
Mailing Address - Country:US
Mailing Address - Phone:803-408-0042
Mailing Address - Fax:
Practice Address - Street 1:1361 SMYRNA RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8968
Practice Address - Country:US
Practice Address - Phone:803-408-0042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP0571253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCIHCP0571OtherSCDHEC