Organization
DIVINE HEALING HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOYCE NYABOKE MOGENI RN (ADMINISTRATOR)
(763) 566-1378
Entity
Organization
Contact information
Practice address
7240 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-1274
(763) 566-1378
(763) 566-1379
Mailing address
7240 BROOKLYN BLVD STE 230, BROOKLYN CENTER, MN 55429-1278
(763) 566-1378
(763) 566-1379
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
384593
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
384593
COMPREHENSIVE HOME CARE LICENSE
MN
Enumeration date
02/28/2018
Last updated
12/16/2024
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