Provider Demographics
NPI:1659517423
Name:DIVINE FAITH HOME CARE SERVICES
Entity Type:Organization
Organization Name:DIVINE FAITH HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:OKWUCHI
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-215-6834
Mailing Address - Street 1:15310 WILDWOOD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5524
Mailing Address - Country:US
Mailing Address - Phone:281-568-5630
Mailing Address - Fax:281-568-5630
Practice Address - Street 1:15310 WILDWOOD LAKE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5524
Practice Address - Country:US
Practice Address - Phone:281-568-5630
Practice Address - Fax:281-568-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities