Provider Demographics
NPI:1104284942
Name:ADVENT DIVINE, INC
Entity type:Organization
Organization Name:ADVENT DIVINE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:D
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-412-8875
Mailing Address - Street 1:7400 LOUIS PASTEUR DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4510
Mailing Address - Country:US
Mailing Address - Phone:210-442-8175
Mailing Address - Fax:210-442-8089
Practice Address - Street 1:7400 LOUIS PASTEUR DR STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4510
Practice Address - Country:US
Practice Address - Phone:210-442-8175
Practice Address - Fax:210-442-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018302OtherTEXAS HOME & COMMUNITY SUPPORT SERVICES AGENCY