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General NPI Number Information
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NPI Number | 1811226764
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Entity Type | Organization
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Legal Business Name | DIVINE PROFESSIONALS HEALTHCARE INC.
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Dates
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Enumeration Date | 12/23/2009
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 7324 SOUTHWEST FWY STE 601
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City | HOUSTON
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State | TX
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Zip | 77074
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Country | US
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Telephone | 832-987-1984
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Fax | 832-539-1952
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Provider Business Mailing Address
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Address Line | 7322 SOUTHWEST FWY STE 868
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City | HOUSTON
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State | TX
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Zip | 77074-2137
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Country | US
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Telephone | 832-987-1984
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Fax | 832-539-1952
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR
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Name | MR. PATRICK ILOANYA
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Credential |
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Telephone | 832-987-1984
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 013159
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License Number State | TX
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