Provider Demographics
NPI:1144271735
Name:DIVINE NURSING SERVICES INC.
Entity type:Organization
Organization Name:DIVINE NURSING SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:AYODELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-464-3900
Mailing Address - Street 1:11211 KATY FWY
Mailing Address - Street 2:310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2126
Mailing Address - Country:US
Mailing Address - Phone:713-464-3900
Mailing Address - Fax:713-464-3901
Practice Address - Street 1:11211 KATY FWY
Practice Address - Street 2:310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2126
Practice Address - Country:US
Practice Address - Phone:713-464-3900
Practice Address - Fax:713-464-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health