| NPI | 1215393269 |
|---|---|
| Doing Business As | DIVINE HOME HEALTH AGENCY |
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN FAYE JACKSON Owner 832-207-5272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-12 |