Provider Demographics
NPI:1003662529
Name:DIVINE JOURNEY HOMECARE
Entity type:Organization
Organization Name:DIVINE JOURNEY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-499-5489
Mailing Address - Street 1:8354 PRINCETON GLENDALE RD STE 216
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2130
Mailing Address - Country:US
Mailing Address - Phone:513-499-5489
Mailing Address - Fax:
Practice Address - Street 1:8354 PRINCETON GLENDALE RD STE 216
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2130
Practice Address - Country:US
Practice Address - Phone:513-499-5489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health