Provider Demographics
NPI:1427601491
Name:DIVINE CARE MANAGEMENT LLC
Entity Type:Organization
Organization Name:DIVINE CARE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:LOBRIN
Authorized Official - Last Name:BARLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:813-434-7651
Mailing Address - Street 1:6414 NIKKI LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1645
Mailing Address - Country:US
Mailing Address - Phone:813-918-0611
Mailing Address - Fax:813-200-8449
Practice Address - Street 1:1012 DRUID RD E STE B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5606
Practice Address - Country:US
Practice Address - Phone:813-434-7651
Practice Address - Fax:813-200-8449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management