Provider Demographics
NPI:1891390241
Name:DIVINE CARE AND WELLNESS LLC
Entity Type:Organization
Organization Name:DIVINE CARE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-719-0020
Mailing Address - Street 1:120 W CHURCH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7813
Mailing Address - Country:US
Mailing Address - Phone:240-696-7048
Mailing Address - Fax:301-618-0407
Practice Address - Street 1:120 W CHURCH ST STE 3B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7813
Practice Address - Country:US
Practice Address - Phone:240-696-7048
Practice Address - Fax:301-618-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health