Pure Divine Independent Care LLC
NPI #1124881966 in Clarksville, Tennessee
Provider Information
- NPI Number
- 1124881966
- Entity Type
- Organization
- Organization Name
- Pure Divine Independent Care LLC
- Primary Specialty
- In Home Supportive Care
- Enumeration Date
- Feb 5, 2024
- Last Updated
- Aug 29, 2024
Practice Location
- Address
- 1860 WILMA RUDOLPH BLVD # 126P
- City
- Clarksville
- State
- Tennessee
- ZIP Code
- 37040-6750
- Phone
- (931) 367-4430
Authorized Official
- Name
- TIFFANY GREEN
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (931) 367-4430
Specialties & Taxonomy Codes
| Specialty |
|---|
| In Home Supportive Care |
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