Divinitycares, Incorporation
NPI #1841280104 in Lake Charles, Louisiana
Provider Information
- NPI Number
- 1841280104
- Entity Type
- Organization
- Organization Name
- Divinitycares, Incorporation
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Oct 26, 2005
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 1202 COMMON ST
- City
- Lake Charles
- State
- Louisiana
- ZIP Code
- 70601-5254
- Phone
- (337) 990-0122
Authorized Official
- Name
- MRS. EDIWNA HARMON BUSHNELL
- Title
- CEO
- Phone
- (337) 990-0122
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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