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General NPI Number Information
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NPI Number | 1467267104
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Entity Type | Organization
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Legal Business Name | DIVINE EMBRACE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 9894 BISSONNET ST STE 312
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City | HOUSTON
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State | TX
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Zip | 77036-8241
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Country | US
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Telephone | 713-255-6806
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1549
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City | MISSOURI CITY
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State | TX
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Zip | 77459-8549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VIOLET IDOKOGI
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Credential |
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Telephone | 281-635-1484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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