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General NPI Number Information
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NPI Number | 1215422316
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Entity Type | Organization
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Legal Business Name | DIVINE HOMEMAKER & COMPANION
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Dates
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Enumeration Date | 06/30/2018
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Last Update Date | 06/30/2018
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Provider Practice Location Address
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Address Line | 7331 SPRING HILL RD
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City | JACKSONVILLE
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State | FL
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Zip | 32244-4273
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Country | US
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Telephone | 904-661-8503
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Fax |
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Provider Business Mailing Address
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Address Line | 7331 SPRING HILL RD
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City | JACKSONVILLE
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State | FL
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Zip | 32244-4273
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Country | US
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Telephone | 904-661-8503
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MANOUCHEKA LAPLANTE
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Credential |
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Telephone | 904-661-8503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 23517
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License Number State | FL
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