Healthcare Provider Details

I. General information

NPI: 1588112569
Provider Name (Legal Business Name): DIVINE HEART SENIOR CAREGIVERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5068 W PLANO PKWY SUITE 300
PLANO TX
75093-4408
US

IV. Provider business mailing address

PO BOX 261612
PLANO TX
75026-1612
US

V. Phone/Fax

Practice location:
  • Phone: 469-988-8263
  • Fax: 972-767-3545
Mailing address:
  • Phone: 469-988-8263
  • Fax: 972-767-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PATTY A DRAKE
Title or Position: PRESIDENT
Credential: RN
Phone: 469-988-8264