Provider Demographics
NPI:1700598190
Name:DIVINE FAVOR HOMECARE SERVICES, LLC.
Entity Type:Organization
Organization Name:DIVINE FAVOR HOMECARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-204-2867
Mailing Address - Street 1:PO BOX 1056
Mailing Address - Street 2:
Mailing Address - City:NORLINA
Mailing Address - State:NC
Mailing Address - Zip Code:27563-1056
Mailing Address - Country:US
Mailing Address - Phone:252-204-2867
Mailing Address - Fax:252-456-3768
Practice Address - Street 1:1922 N GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2723
Practice Address - Country:US
Practice Address - Phone:252-204-2867
Practice Address - Fax:252-456-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care