# DIVINELY CHOSEN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306717061
- **Authorized official:** MR. KEONDRA JOHNSON PN5256124 (LPN)
- **Authorized official phone:** (689) 290-6060

## Contact information

- **Practice address:** 3261 US 441, SUITE B2, FRUITLAND PARK, FL 34731
- **Practice address phone:** (689) 290-6060
- **Mailing address:** 5252 HARTWOOD LOOP, WILDWOOD, FL 34785-7926
- **Mailing address phone:** (689) 290-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/16/2025
- **Last updated:** 09/16/2025