Organization
DIVINE COMPANION CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARKEDRA LYNNELL WHEATLEY (OWNER)
(318) 243-1743
Entity
Organization
Contact information
Practice address
616 MCDONALD AVE, RUSTON, LA 71270-4627
(318) 243-1743
Mailing address
616 MCDONALD AVE, RUSTON, LA 71270-4627
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/10/2018
Last updated
06/16/2018
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