Provider Demographics
NPI:1104542117
Name:DEVINE GROUP HOME CARE LLC
Entity type:Organization
Organization Name:DEVINE GROUP HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAGBAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-554-7885
Mailing Address - Street 1:2811 HARDY PL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-2408
Mailing Address - Country:US
Mailing Address - Phone:682-554-7885
Mailing Address - Fax:682-252-4705
Practice Address - Street 1:2811 HARDY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-2408
Practice Address - Country:US
Practice Address - Phone:682-554-7885
Practice Address - Fax:682-252-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care HomeGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty