Provider Demographics
NPI:1750199857
Name:DIVINE COMMUNITY AFC, INC
Entity type:Organization
Organization Name:DIVINE COMMUNITY AFC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SULEIMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-375-8333
Mailing Address - Street 1:300 WEST MAIN ST BUILDING C SUITE 1 & 2
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532
Mailing Address - Country:US
Mailing Address - Phone:508-466-8050
Mailing Address - Fax:617-934-7265
Practice Address - Street 1:300 WEST MAIN ST BUILDING C SUITE 1 & 2
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532
Practice Address - Country:US
Practice Address - Phone:508-466-8050
Practice Address - Fax:617-934-7265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health