Provider Demographics
NPI:1326835299
Name:DIVINE INTERVENTION HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:DIVINE INTERVENTION HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:BAYLOR
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-792-7073
Mailing Address - Street 1:807 SWEETBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3346
Mailing Address - Country:US
Mailing Address - Phone:318-792-7073
Mailing Address - Fax:
Practice Address - Street 1:807 SWEETBRIAR DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3346
Practice Address - Country:US
Practice Address - Phone:318-792-7073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care