Provider Demographics
NPI:1790384204
Name:DEVOTED HOMECARE SERVICES, LLC
Entity Type:Organization
Organization Name:DEVOTED HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BSW, MS
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABOLEH
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:302-384-1248
Mailing Address - Street 1:11 CORALBERRY DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3928
Mailing Address - Country:US
Mailing Address - Phone:302-384-1248
Mailing Address - Fax:
Practice Address - Street 1:11 CORALBERRY DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3928
Practice Address - Country:US
Practice Address - Phone:302-384-1248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities