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General NPI Number Information
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NPI Number | 1265396584
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Entity Type | Organization
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Legal Business Name | DIVINE HARVEST HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 2605 CORNWALL DR
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City | MCDONOUGH
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State | GA
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Zip | 30253-6875
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Country | US
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Telephone | 678-544-9234
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Fax | 678-759-1775
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Provider Business Mailing Address
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Address Line | 2605 CORNWALL DR
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City | MCDONOUGH
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State | GA
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Zip | 30253-6875
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YOLANDA HARRIS
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Credential |
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Telephone | 678-544-9234
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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