Provider Demographics
NPI:1437942539
Name:DIVINE TOUCH WOUND CARE
Entity type:Organization
Organization Name:DIVINE TOUCH WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELESTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAJOYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-961-9379
Mailing Address - Street 1:1200 S FIGUEROA ST APT E1007
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1392
Mailing Address - Country:US
Mailing Address - Phone:909-755-5166
Mailing Address - Fax:909-755-5188
Practice Address - Street 1:9333 BASE LINE RD STE 190
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1300
Practice Address - Country:US
Practice Address - Phone:909-755-5166
Practice Address - Fax:909-755-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service