# DIVERGENT SERVICES

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

## Provider details

- **NPI number:** 1821300245
- **Authorized official:** MRS. KENNIE NICOLE JACKSON WALCOTT (OWNER/CAREGIVER)
- **Authorized official phone:** (317) 362-3792

## Contact information

- **Practice address:** 3955 CAMPBELL AVE, INDIANAPOLIS, IN 46226-4836
- **Practice address phone:** (317) 362-3792
- **Mailing address:** 3955 CAMPBELL AVE, INDIANAPOLIS, IN 46226-4836
- **Mailing address phone:** (317) 362-3792

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 332U00000X | Home Delivered Meals | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 07/14/2010
- **Last updated:** 07/14/2010