Provider Demographics
NPI:1417429663
Name:DEVINE COMPANIONS & MEDICAL BILLING
Entity Type:Organization
Organization Name:DEVINE COMPANIONS & MEDICAL BILLING
Other - Org Name:A DEVINE COMPANION INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NERRICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-544-9912
Mailing Address - Street 1:2431 ALOMA AVE STE 158
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2541
Mailing Address - Country:US
Mailing Address - Phone:407-544-9912
Mailing Address - Fax:407-574-7934
Practice Address - Street 1:2431 ALOMA AVE # 124
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-544-9912
Practice Address - Fax:407-574-7934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024463400Medicaid
FL102594600Medicaid