Organization · NPI-2

Divine Health Care

In Home Supportive Care · Plano, TX

NPI number1285243345

StatusActive

Last updated in NPPESSep 14, 2020

Details

NPI: 1285243345
Entity type: Organization (NPI-2)
Legal business name: Divine Health Care
Organization subpart: No
Enumeration date: Jul 24, 2020
Certification date: Sep 14, 2020
Last updated: Sep 14, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
253Z00000X	In Home Supportive Care	–	–	Yes
251B00000X	Case Management	–	–
305R00000X	Preferred Provider Organization	–	–
305S00000X	Point of Service	–	–
311ZA0620X	Custodial Care Facility, Adult Care Home	–	–
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–
372600000X	Adult Companion	–	–
3747A0650X	Technician, Attendant Care Provider	–	–
3747P1801X	Technician, Personal Care Attendant	–	–
385H00000X	Respite Care	–	–
385HR2065X	Respite Care, Respite Care, Physical Disabilities, Child	–	–

Practice location

5851 Legacy Cir Ste 600
Plano, TX 75024-5969

Phone 501-353-8568

Mailing address

5851 Legacy Cir Ste 600
Plano, TX 75024-5969

Phone 501-353-8568

Authorized official

Latoyal Robinson
Owner
5013535392

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