Provider Demographics
NPI:1851649206
Name:DEVINECARE SERVICES
Entity Type:Organization
Organization Name:DEVINECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AQUEEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANYANWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-462-9955
Mailing Address - Street 1:22006 RANIER LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2603
Mailing Address - Country:US
Mailing Address - Phone:210-462-9955
Mailing Address - Fax:
Practice Address - Street 1:22006 RANIER LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-2603
Practice Address - Country:US
Practice Address - Phone:210-462-9955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility