Provider Demographics
NPI:1083234900
Name:DIVINE GRACE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:DIVINE GRACE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-705-2443
Mailing Address - Street 1:515 N SAM HOUSTON PKWY E STE 320
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4139
Mailing Address - Country:US
Mailing Address - Phone:281-809-3123
Mailing Address - Fax:877-313-0955
Practice Address - Street 1:515 N SAM HOUSTON PKWY E STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4139
Practice Address - Country:US
Practice Address - Phone:281-809-3123
Practice Address - Fax:877-313-0955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based