Provider Demographics
NPI:1588112569
Name:DIVINE HEART SENIOR CAREGIVERS INC
Entity type:Organization
Organization Name:DIVINE HEART SENIOR CAREGIVERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-988-8264
Mailing Address - Street 1:PO BOX 261612
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-1612
Mailing Address - Country:US
Mailing Address - Phone:469-988-8263
Mailing Address - Fax:972-767-3545
Practice Address - Street 1:5068 W PLANO PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4408
Practice Address - Country:US
Practice Address - Phone:469-988-8263
Practice Address - Fax:972-767-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health