Provider Demographics
NPI:1467118901
Name:DIVINE GLORY SERVICES LLC
Entity Type:Organization
Organization Name:DIVINE GLORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ADENIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-878-0091
Mailing Address - Street 1:16823 CLOLA CT. RICHMOND, TX. 77407-1211
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1211
Mailing Address - Country:US
Mailing Address - Phone:832-878-0091
Mailing Address - Fax:
Practice Address - Street 1:16823 CLOLA CT. RICHMOND, TX. 77407-1211
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1211
Practice Address - Country:US
Practice Address - Phone:832-878-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health