Provider Demographics
NPI:1750055331
Name:DIVINELY ALIGNED PRENATAL CARE COORDINATION LLC
Entity Type:Organization
Organization Name:DIVINELY ALIGNED PRENATAL CARE COORDINATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERNESTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-520-9635
Mailing Address - Street 1:9710 W GREENWOOD TER
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-3920
Mailing Address - Country:US
Mailing Address - Phone:414-520-9635
Mailing Address - Fax:
Practice Address - Street 1:9710 W GREENWOOD TER
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-3920
Practice Address - Country:US
Practice Address - Phone:414-520-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management