Provider Demographics
NPI:1013298306
Name:DIVINAS PRIMARY HOME CARE INC.
Entity Type:Organization
Organization Name:DIVINAS PRIMARY HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANNETTE
Authorized Official - Middle Name:DENNAIDA
Authorized Official - Last Name:CERDA
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:956-874-4620
Mailing Address - Street 1:3308 UVALDE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-8383
Mailing Address - Country:US
Mailing Address - Phone:956-874-4620
Mailing Address - Fax:956-874-4621
Practice Address - Street 1:3308 UVALDE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-8383
Practice Address - Country:US
Practice Address - Phone:956-874-4620
Practice Address - Fax:956-874-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health