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General NPI Number Information
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NPI Number | 1649538950
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Entity Type | Organization
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Legal Business Name | DIVINE TORCH HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 110 W RANDOL MILL RD STE 242
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City | ARLINGTON
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State | TX
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Zip | 76011-4731
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Country | US
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Telephone | 817-225-2160
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Fax | 817-225-2161
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Provider Business Mailing Address
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Address Line | 110 W RANDOL MILL RD STE 242
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City | ARLINGTON
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State | TX
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Zip | 76011-4731
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Country | US
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Telephone | 817-225-2160
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Fax | 817-225-2161
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Authorized Official
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Title or Position | RN/CEO/ADMINISTRATOR
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Name | VIVIAN NGUM NGANG
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Credential |
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Telephone | 817-225-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 014746
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License Number State | TX
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