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Organization

DIVINITYCARES, INCORPORATION

Active
Other names
hospice
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. EDIWNA HARMON BUSHNELL (CEO)
(337) 990-0122
Entity
Organization

Contact information

Practice address
1202 COMMON ST, LAKE CHARLES, LA 70601-5254
(337) 990-0122
(337) 990-0124
Mailing address
1202 COMMON ST, LAKE CHARLES, LA 70601-5254
(337) 990-0122
(337) 990-0124

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
LA

Other

Enumeration date
10/26/2005
Last updated
07/21/2022
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