Chas Van Diviere LTD
Organization Active NPI Case Manager/Care Coordinator · Tignall, GA
NPI 1619033149 · NPPES record last updated Jul 23, 2008
Key facts
- NPI
- 1619033149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Legal business name
- CHAS VAN DIVIERE LTD
- Practice address
- 357 Boyce Guin Rd
Tignall, GA 30668 - Phone
- (706) 285-2073
- Fax
- (706) 285-2076
- NPI assigned
- Dec 29, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CHAS VAN DIVIERE LTD
Authorized official
- Name
- Mr. Chas L Van Diviere Jr.
- Title
- Pres
- Phone
- (706) 285-2073
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Chas Van Diviere LTD
- Part of
- Chas Van Diviere LTD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator |
171M00000X | Yes |
Addresses
Primary practice location
357 Boyce Guin Rd
Tignall, GA 30668
Mailing address
357 Boyce Guin Rd
Tignall, GA 30668
Phone (706) 285-2073
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00530406A | Medicaid | GA |
Other names
- Diveres Home Services
Other providers in Tignall, GA
- Tena Austin Blakey
- Charlie Van Diviere LTD
- Country Manor Personal Care Home, Inc
- David Manning Stubbs
- The Armour House
- Tignall Assisted Living, LLC
- Tynisha Walton
All providers in Tignall, GA · Case Manager/Care Coordinator in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.