Provider Demographics
NPI:1679214845
Name:DIVINE HEALTHCARE CONSULTANTS LLC
Entity Type:Organization
Organization Name:DIVINE HEALTHCARE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRI-ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:
Authorized Official - Credentials:LVN-WCN-C
Authorized Official - Phone:832-228-6988
Mailing Address - Street 1:34 WOOD DRAKE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4972
Mailing Address - Country:US
Mailing Address - Phone:832-319-0453
Mailing Address - Fax:866-525-0270
Practice Address - Street 1:34 WOOD DRAKE PLACE
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:832-319-0453
Practice Address - Fax:866-525-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No251J00000XAgenciesNursing Care