Divine Boyd Enterprise LLC

NPI #1427472133 in Desoto, Texas

Provider Information

NPI Number: 1427472133
Entity Type: Organization
Organization Name: Divine Boyd Enterprise LLC
Primary Specialty: Custodial Care Facility
Enumeration Date: Feb 17, 2014
Last Updated: Feb 17, 2014

Practice Location

Address: 117 CRYSTAL LAKE DR
City: Desoto
State: Texas
ZIP Code: 75115-3799
Phone: (253) 459-0863

Authorized Official

Name: JOY BOYD
Title: MANAGING MEMBER
Phone: (253) 459-0863

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Custodial Care Facility	311Z00000X	Primary

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