Provider Demographics
NPI:1023991973
Name:DIVINE HEARTS COMPANY
Entity type:Organization
Organization Name:DIVINE HEARTS COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-751-7917
Mailing Address - Street 1:1702 DEARBOUGHT DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-9383
Mailing Address - Country:US
Mailing Address - Phone:843-751-7917
Mailing Address - Fax:
Practice Address - Street 1:9053 TWO BAYS RD
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1594
Practice Address - Country:US
Practice Address - Phone:843-751-7917
Practice Address - Fax:571-492-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care