Provider Demographics
NPI:1205609682
Name:DIVINE PLACE NURSING & STAFFING
Entity type:Organization
Organization Name:DIVINE PLACE NURSING & STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-405-8611
Mailing Address - Street 1:1935 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6796
Mailing Address - Country:US
Mailing Address - Phone:817-405-8611
Mailing Address - Fax:
Practice Address - Street 1:1935 W STATE ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6796
Practice Address - Country:US
Practice Address - Phone:817-405-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty