Provider Demographics
NPI:1114356987
Name:DIVINE CAREGIVERS INC.
Entity Type:Organization
Organization Name:DIVINE CAREGIVERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-259-2532
Mailing Address - Street 1:2217 BLODGETT ST STE 333
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5217
Mailing Address - Country:US
Mailing Address - Phone:832-259-2532
Mailing Address - Fax:713-521-1277
Practice Address - Street 1:2217 BLODGETT ST STE 333
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5217
Practice Address - Country:US
Practice Address - Phone:832-259-2532
Practice Address - Fax:713-521-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health