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General NPI Number Information
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NPI Number | 1699915975
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Entity Type | Organization
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Legal Business Name | DIVINE INTERVENTION HOME HEALTH, INC
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 13123 OAKWOOD MANOR DR
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City | CYPRESS
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State | TX
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Zip | 77429-4924
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Country | US
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Telephone | 713-732-1526
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Fax | 281-746-7332
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Provider Business Mailing Address
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Address Line | 13123 OAKWOOD MANOR DR
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City | CYPRESS
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State | TX
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Zip | 77429-4924
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Country | US
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Telephone | 713-732-1526
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Fax | 281-746-7332
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MS. NICHOLE MICHELLE LEE
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Credential | RN
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Telephone | 713-732-1526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 699882
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License Number State | TX
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