Divine Healing Senior & Disabled Services LLC

Organization Active NPI In Home Supportive Care Agency · Midway, FL

NPI 1679194237 · NPPES record last updated Jun 22, 2023

Key facts

NPI
1679194237
Entity type
Organization (NPI type 2)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Legal business name
DIVINE HEALING SENIOR & DISABLED SERVICES LLC
Practice address
8866 High Bridge Rd
Midway, FL 32343
Phone
(850) 274-7104
NPI assigned
May 5, 2020
Organization subpart
No

Authorized official

Name
Decorkus Allen
Title
Ceo
Phone
(850) 274-7104

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

8866 Highbridge Rd
Midway, FL 32343
Phone (850) 274-7104

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

8866 High Bridge Rd
Midway, FL 32343

Mailing address

211 Gay St
Havana, FL 32333-1646
Phone (850) 274-7104

Other practice location 1

171 Bear Creek Rd
Quincy, FL 32351-7937
Phone (850) 274-7104

Other practice location 2

211 Gay St
Havana, FL 32333-1646
Phone (850) 274-7104

Other identifiers

IdentifierTypeStateIssuer
021500500MedicaidFL
114242100MedicaidFL

Other names

  • Decorkus V Allen Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Other URL havanathomas@aol.com
Other URL havanathomas@aol.com
Other URL havanathomas@aol.com

Other providers in Midway, FL

All providers in Midway, FL · In Home Supportive Care Agency in Florida

Sources for this page

Verify at the official NPI Registry.