Provider Demographics
NPI:1497943534
Name:DIVINETOUCH HEALTH SERVICES
Entity Type:Organization
Organization Name:DIVINETOUCH HEALTH SERVICES
Other - Org Name:DIVINE TOUCH HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ONUNGWANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUNGWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-839-5585
Mailing Address - Street 1:4402 BROADWAY BLVD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:214-703-0295
Mailing Address - Fax:214-703-0296
Practice Address - Street 1:4402 BROADWAY BLVD
Practice Address - Street 2:SUITE #7
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:214-703-0295
Practice Address - Fax:214-703-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747142Medicare Oscar/Certification