Provider Demographics
NPI:1730994781
Name:DIVINE DUNAMIS DWELLING INC
Entity type:Organization
Organization Name:DIVINE DUNAMIS DWELLING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELPHINA
Authorized Official - Middle Name:CHIKAMELE
Authorized Official - Last Name:MITIMA-SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:409-350-8167
Mailing Address - Street 1:6401 SOUTHWEST FWY STE 200A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2205
Mailing Address - Country:US
Mailing Address - Phone:409-350-8167
Mailing Address - Fax:713-583-1351
Practice Address - Street 1:6401 SOUTHWEST FWY STE 200A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2205
Practice Address - Country:US
Practice Address - Phone:409-350-8167
Practice Address - Fax:713-583-1351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility