Provider Demographics
NPI:1144602384
Name:DIVINE PALLIATIVE AND HEALTH SERVICES INC
Entity Type:Organization
Organization Name:DIVINE PALLIATIVE AND HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIDUBEM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIWUZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-835-4703
Mailing Address - Street 1:10039 BISSONNET ST STE 148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7863
Mailing Address - Country:US
Mailing Address - Phone:713-835-4703
Mailing Address - Fax:
Practice Address - Street 1:10039 BISSONNET ST STE 148
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7863
Practice Address - Country:US
Practice Address - Phone:713-835-4703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based