Organization
DIVINE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY JOHNSON (CEO)
(816) 780-1680
Entity
Organization
Contact information
Practice address
9756 LOCUST ST, KANSAS CITY, MO 64131-4143
(816) 912-4343
Mailing address
9756 LOCUST ST, KANSAS CITY, MO 64131-4143
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
04/01/2024
Last updated
08/08/2025
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