Organization
HEAVENLY DIVINE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA JOHNSON (OWNER)
(843) 601-8024
Entity
Organization
Contact information
Practice address
1203 N SALLY HILL RD, TIMMONSVILLE, SC 29161-9307
(843) 593-2626
Mailing address
1306 N SALLY HILL RD, TIMMONSVILLE, SC 29161-9307
(843) 601-8024
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
09/14/2023
Last updated
11/13/2023
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