Provider Demographics
NPI:1699106393
Name:GENTLE DIVINE TOUCH HOME CARE & CONCIERGE SERVICES
Entity type:Organization
Organization Name:GENTLE DIVINE TOUCH HOME CARE & CONCIERGE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-225-2884
Mailing Address - Street 1:4220 SPID DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4479
Mailing Address - Country:US
Mailing Address - Phone:361-225-2884
Mailing Address - Fax:361-225-2885
Practice Address - Street 1:4220 SPID DR
Practice Address - Street 2:SUITE 114
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4479
Practice Address - Country:US
Practice Address - Phone:361-225-2884
Practice Address - Fax:361-225-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015788251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care