Provider Demographics
NPI:1851136568
Name:DEVINE FAMILY CORP
Entity type:Organization
Organization Name:DEVINE FAMILY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYABAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-549-0565
Mailing Address - Street 1:9931 63RD RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1939
Mailing Address - Country:US
Mailing Address - Phone:347-549-0565
Mailing Address - Fax:
Practice Address - Street 1:9931 63RD RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1939
Practice Address - Country:US
Practice Address - Phone:347-549-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care