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General NPI Number Information
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NPI Number | 1518480813
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Entity Type | Organization
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Legal Business Name | DIVINE PURPOSE CARE HOME, LLC
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5742 SCHEVERS ST
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City | HOUSTON
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State | TX
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Zip | 77033
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Country | US
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Telephone | 713-505-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 5742 SCHEVERS ST
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City | HOUSTON
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State | TX
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Zip | 77033-2316
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Country | US
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Telephone | 713-505-1627
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Fax |
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Authorized Official
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Title or Position | HEALTH CARE ADMINISTRATOR/ OWNER
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Name | MRS. ANDREA WALKER
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Credential |
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Telephone | 832-620-0780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 147540
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License Number State | TX
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