Organization
DIVINE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA O BALOGUN (PRESIDENT)
(972) 400-3186
Entity
Organization
Contact information
Practice address
3354 MEADOWSIDE DR, SACHSE, TX 75048-2270
(972) 400-3186
Mailing address
3354 MEADOWSIDE DRIVE, SACHSE, TX 75048
(972) 400-3186
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802713080
NONE
TX
Enumeration date
05/11/2017
Last updated
05/11/2017
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