Provider Demographics
NPI:1699497487
Name:DIVINE CARE HOSPICE LLC
Entity type:Organization
Organization Name:DIVINE CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-733-7278
Mailing Address - Street 1:8330 LBJ FWY STE 460
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1210
Mailing Address - Country:US
Mailing Address - Phone:469-733-7278
Mailing Address - Fax:
Practice Address - Street 1:8330 LBJ FWY STE 460
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1210
Practice Address - Country:US
Practice Address - Phone:469-733-7278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health