Provider Demographics
NPI:1215422316
Name:DIVINE HOMEMAKER & COMPANION
Entity type:Organization
Organization Name:DIVINE HOMEMAKER & COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANOUCHEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-661-8503
Mailing Address - Street 1:7331 SPRING HILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-4273
Mailing Address - Country:US
Mailing Address - Phone:904-661-8503
Mailing Address - Fax:
Practice Address - Street 1:7331 SPRING HILL RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-4273
Practice Address - Country:US
Practice Address - Phone:904-661-8503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-30
Last Update Date:2018-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23517251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health