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Organization
DIVINE HEALTH CARE
Active
Organization
DIVINE HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYAL ROBINSON (OWNER)
(501) 353-5392
Entity
Organization
Contact information
Practice address
5851 LEGACY CIR STE 600, PLANO, TX 75024-5969
(501) 353-8568
Mailing address
5851 LEGACY CIR STE 600, PLANO, TX 75024-5969
(501) 353-8568
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
305R00000X
Preferred Provider Organization
—
NULL
305S00000X
Point of Service
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
372600000X
Adult Companion
—
NULL
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
NULL
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
385H00000X
Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
07/24/2020
Last updated
09/14/2020
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