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Organization
DIVINELY CHOSEN SERVICES
Active
Organization
DIVINELY CHOSEN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEONDRA JOHNSON PN5256124 (LPN)
(689) 290-6060
Entity
Organization
Contact information
Practice address
3261 US 441, SUITE B2, FRUITLAND PARK, FL 34731
(689) 290-6060
Mailing address
5252 HARTWOOD LOOP, WILDWOOD, FL 34785-7926
(689) 290-6060
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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