Provider Demographics
NPI:1205270576
Name:DEVINE CARE PLUS LLC
Entity type:Organization
Organization Name:DEVINE CARE PLUS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOQUEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-225-1492
Mailing Address - Street 1:6024 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4287
Mailing Address - Country:US
Mailing Address - Phone:561-225-1492
Mailing Address - Fax:877-239-4406
Practice Address - Street 1:6024 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4287
Practice Address - Country:US
Practice Address - Phone:561-225-1492
Practice Address - Fax:877-239-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233175171W00000X
FL30211800251J00000X, 253Z00000X, 385H00000X, 251E00000X, 385H00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Single Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016017100Medicaid