Provider Demographics
NPI:1801518220
Name:DEVINITY HOME HEALTH & PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:DEVINITY HOME HEALTH & PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUBANWO (GINA)
Authorized Official - Middle Name:A
Authorized Official - Last Name:OMISANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-570-4072
Mailing Address - Street 1:9102 ASPEN TRACE LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2802
Mailing Address - Country:US
Mailing Address - Phone:281-570-4072
Mailing Address - Fax:
Practice Address - Street 1:9102 ASPEN TRACE LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2802
Practice Address - Country:US
Practice Address - Phone:281-570-4072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty