Provider Demographics
NPI:1568843258
Name:DEVONSHIRE HEALTHCARE SYSTEMS, INC.,
Entity Type:Organization
Organization Name:DEVONSHIRE HEALTHCARE SYSTEMS, INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVARISTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ULINFUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-877-6709
Mailing Address - Street 1:703 INDEPENDENCE LN
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-3728
Mailing Address - Country:US
Mailing Address - Phone:303-877-6709
Mailing Address - Fax:
Practice Address - Street 1:703 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-3728
Practice Address - Country:US
Practice Address - Phone:303-877-6709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251F00000XAgenciesHome Infusion
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care