Organization
DIVINE HOME CARE SERVICES
Active
Parent organization
JOHNSON DIAGNOSTIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHNSON DIAGNOSTIC LLC
Authorized official
WANKETHIA JOHNSON (CEO)
(833) 385-3874
Entity
Organization
Contact information
Practice address
121 FRONT STREET, PURVIS, MS 39475
(833) 385-3874
Mailing address
121 FRONT STREET, PURVIS, MS 39475
(833) 385-3874
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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