Divine Alternative Personal Care Home

NPI #1407114879 in Lithonia, Georgia

Provider Information

NPI Number
1407114879
Entity Type
Organization
Organization Name
Divine Alternative Personal Care Home
Primary Specialty
Point of Service
Enumeration Date
Apr 24, 2012
Last Updated
Apr 24, 2012

Practice Location

Address
1728 RICE SQ
State
Georgia
ZIP Code
30058-3257
Phone
(404) 981-4056

Authorized Official

Name
LA TANYA LESTER-HAYES
Title
CEO
Phone
(404) 981-4056

Specialties & Taxonomy Codes

Specialty
Point of Service

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