Provider Demographics
NPI:1891466439
Name:DIVINE HOME CARE SERVICES
Entity Type:Organization
Organization Name:DIVINE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERDEGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:254-294-3896
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76645-1018
Mailing Address - Country:US
Mailing Address - Phone:254-294-3896
Mailing Address - Fax:254-294-3882
Practice Address - Street 1:127 E ELM ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-3320
Practice Address - Country:US
Practice Address - Phone:254-294-3896
Practice Address - Fax:254-294-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care