Organization
DIVINE HOME & HEALTH SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE KELLUM (HOME HEALTH-RN)
(313) 915-1768
Entity
Organization
Contact information
Practice address
30610 WOODSTOCK ST, SOUTHFIELD, MI 48076-1260
(313) 915-1768
Mailing address
30610 WOODSTOCK ST, SOUTHFIELD, MI 48076-1260
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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