NPI 1124881966
Pure Divine Independent Care LLC
Practice location
- Address
- 1860 Wilma Rudolph Blvd # 126p, Clarksville, TN 37040-6750
- Phone
- (931) 367-4430
- Mailing address
- 1960 Madison St STE J178, Clarksville, TN 37043-8063
Authorised official
- Name
- Tiffany Green
- Title
- Chief Executive Officer
- Phone
- (931) 367-4430
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1124881966
- Entity type
- Organization
- NPI issued
- 5 Feb 2024
- Record last updated
- 29 Aug 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.