Organization
DIVINE PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA V JOHNSON (OWNER/ADMINISTRATOR)
(414) 461-5763
Entity
Organization
Contact information
Practice address
10111 W CAPITOL DR STE 4, WAUWATOSA, WI 53222-1335
(414) 461-5763
Mailing address
10111 W CAPITOL DR, SUITE 4, WAUWATOSA, WI 53222
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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