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General NPI Number Information
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NPI Number | 1497489322
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Entity Type | Organization
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Legal Business Name | AJA DIVINE HEALING
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 14407 SWANFIELD DR
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City | HOUSTON
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State | TX
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Zip | 77083-6140
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Country | US
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Telephone | 346-815-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 11212 WESTPARK DR APT 814
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City | HOUSTON
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State | TX
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Zip | 77042-5072
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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 | CEO
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Name | JEANETTE DALISIA JOHNSON
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Credential |
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Telephone | 346-815-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management 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 | 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 #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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