Provider Demographics
NPI:1437418936
Name:DIVINE SHEPARD HOME HEALTH INC
Entity Type:Organization
Organization Name:DIVINE SHEPARD HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWABUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-341-9335
Mailing Address - Street 1:521 CARAVACA DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5115
Mailing Address - Country:US
Mailing Address - Phone:214-341-9335
Mailing Address - Fax:214-341-9335
Practice Address - Street 1:521 CARAVACA DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5115
Practice Address - Country:US
Practice Address - Phone:214-341-9335
Practice Address - Fax:214-341-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health