Divine Home Care Changes
NPI #1174132476 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1174132476
- Entity Type
- Organization
- Organization Name
- Divine Home Care Changes
- Primary Specialty
- In Home Supportive Care
- Enumeration Date
- Jul 23, 2020
- Last Updated
- Oct 7, 2022
Practice Location
- Address
- 106 ETHEL DR
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-8905
- Phone
- (919) 339-1854
Authorized Official
- Name
- CHASITY DAVIS
- Title
- CEO
- Phone
- (919) 339-1854
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
| Community/Behavioral Health |
| In Home Supportive Care |
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