| Divinity Healthcare Services | |
|
504 N Main St Homer LA 71040-3915 | |
| (318) 265-4542 | |
| Not Available |
| Full Name | Divinity Healthcare Services |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 504 N Main St, Homer, Louisiana |
| Authorized Official Name and Position | Ekara Wafer-mendenhall (CEO/ OWNER) |
| Authorized Official Contact | 3182654542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divinity Healthcare Services 504 N Main St Homer LA 71040-3915 Ph: (318) 265-4542 | Divinity Healthcare Services 504 N Main St Homer LA 71040-3915 Ph: (318) 265-4542 |
| NPI Number | 1518719483 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 07/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518719483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
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