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General NPI Number Information
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NPI Number | 1023991973
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Entity Type | Organization
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Legal Business Name | DIVINE HEARTS COMPANY
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 9053 TWO BAYS RD
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City | LORTON
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State | VA
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Zip | 22079-1594
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Country | US
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Telephone | 843-751-7917
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Fax | 571-492-9629
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Provider Business Mailing Address
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Address Line | 1702 DEARBOUGHT DR
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City | FREDERICK
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State | MD
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Zip | 21701-9383
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Country | US
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Telephone | 843-751-7917
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANGELA MICHELLE JOHNSON
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Credential |
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Telephone | 843-751-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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