Provider Demographics
NPI:1356803381
Name:DIVINE HEALTH CONSULTANTS, LLC
Entity type:Organization
Organization Name:DIVINE HEALTH CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:O
Authorized Official - Last Name:AFAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-448-0251
Mailing Address - Street 1:5633 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-5591
Mailing Address - Country:US
Mailing Address - Phone:803-448-0251
Mailing Address - Fax:704-512-0165
Practice Address - Street 1:5633 MONROE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5591
Practice Address - Country:US
Practice Address - Phone:803-448-0251
Practice Address - Fax:704-512-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty