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Organization
DIVINITY CARES INCORPORATION
Active
Organization
DIVINITY CARES INCORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EDWINA HARMON BUSHNELL (CEO/FOUNDER)
(337) 497-1871
Entity
Organization
Contact information
Practice address
1605 BROAD ST, SUITE 16, LAKE CHARLES, LA 70601-4602
(337) 497-1871
(337) 497-1876
Mailing address
1605 BROAD ST STE 16, LAKE CHARLES, LA 70601-4602
(337) 497-1871
(337) 497-1876
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
LA
251G00000X
Community Based Hospice Care Agency
—
LA
253Z00000X
In Home Supportive Care Agency
—
LA
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
LA
302F00000X
Exclusive Provider Organization
—
LA
332B00000X
Durable Medical Equipment & Medical Supplies
—
LA
332BC3200X
Customized Equipment (DME)
—
LA
332BD1200X
Dialysis Equipment & Supplies (DME)
—
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
LA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
LA
Other
Enumeration date
07/02/2010
Last updated
11/02/2010
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