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General NPI Number Information
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NPI Number | 1912520529
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Entity Type | Organization
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Legal Business Name | DIVINE HUMANITY HOMECARE LLC.
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 841 PRUDENTIAL DR STE 1214
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8329
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Country | US
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Telephone | 904-371-6586
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Fax |
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Provider Business Mailing Address
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Address Line | 841 PRUDENTIAL DR STE 1214
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8329
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Country | US
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Telephone | 904-371-6586
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. MONICA ANDREA PARKS
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Credential |
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Telephone | 904-413-6381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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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Taxonomy #4
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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