Provider Demographics
NPI:1245582105
Name:OMEGA DIVINE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:OMEGA DIVINE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOREGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-382-7784
Mailing Address - Street 1:102 E ALAMO ST STE 200E
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-3792
Mailing Address - Country:US
Mailing Address - Phone:979-661-1585
Mailing Address - Fax:979-393-0087
Practice Address - Street 1:1302 FOREST HOLLOW DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1500
Practice Address - Country:US
Practice Address - Phone:979-661-1585
Practice Address - Fax:979-393-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health