Provider Demographics
NPI:1558964387
Name:ABSOLUTELY DIVINE HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:ABSOLUTELY DIVINE HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-485-8463
Mailing Address - Street 1:PO BOX 35781
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-0781
Mailing Address - Country:US
Mailing Address - Phone:910-485-8463
Mailing Address - Fax:
Practice Address - Street 1:325 MCGILL AVE NW STE 524
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6239
Practice Address - Country:US
Practice Address - Phone:704-848-5950
Practice Address - Fax:910-480-0574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABSOLUTELY DIVINE HOME CARE AGENCY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-16
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care