Provider Demographics
NPI:1477148906
Name:ACL. DIVINE QUALITY HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:ACL. DIVINE QUALITY HOME HEALTH AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-416-4685
Mailing Address - Street 1:11052 CAPTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5008
Mailing Address - Country:US
Mailing Address - Phone:813-416-4685
Mailing Address - Fax:813-416-4685
Practice Address - Street 1:11052 CAPTAIN DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5008
Practice Address - Country:US
Practice Address - Phone:813-416-4685
Practice Address - Fax:813-416-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health