NPI 1487054300

Divine Home Care

Organisation Adult Care Home Facility Dothan, AL

Practice location

Address: 802 Grant St APT 3, Dothan, AL 36301-3807
Phone: (334) 405-5881

Authorised official

Name: Derrick O Tiller
Title: Owner
Phone: (334) 405-5881

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

Other Custodial Care Facility providers in Alabama →

Registry record

NPI: 1487054300
Entity type: Organization
NPI issued: 27 Aug 2014
Record last updated: 27 Aug 2014

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.