NPI 1407114879

Divine Alternative Personal Care Home

Organisation Point of Service Lithonia, GA

Practice location

Address: 1728 Rice Sq, Lithonia, GA 30058-3257
Phone: (404) 981-4056
Mailing address: 1728 Rice Square, Lithonia, GA 30058

Authorised official

Name: La Tanya Lester-Hayes
Title: Ceo
Phone: (404) 981-4056

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Georgia →

Registry record

NPI: 1407114879
Entity type: Organization
NPI issued: 24 Apr 2012
Record last updated: 24 Apr 2012

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.