Provider Demographics
NPI:1720853344
Name:DIVINE SOLIUTION CARE LLC
Entity Type:Organization
Organization Name:DIVINE SOLIUTION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMSON
Authorized Official - Middle Name:B
Authorized Official - Last Name:AILOHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-685-5478
Mailing Address - Street 1:10721 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-6943
Mailing Address - Country:US
Mailing Address - Phone:313-685-5478
Mailing Address - Fax:313-438-6934
Practice Address - Street 1:10721 MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6943
Practice Address - Country:US
Practice Address - Phone:313-685-5478
Practice Address - Fax:313-438-6934
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIVINE SOLUTION CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care