Organization
DIVINE HOSPICE INC
Active
Organization
DIVINE HOSPICE INC
Active
Other names
Professional Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONSOLOTA BRYANT RN (ADMINISTRATOR)
(817) 268-1946
Entity
Organization
Contact information
Practice address
345 WESTPARK WAY, #101, EULESS, TX 76040-3913
(817) 268-1946
(817) 268-0209
Mailing address
345 WESTPARK WAY, #101, EULESS, TX 76040-3913
(817) 268-1946
(817) 268-0722
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
008914
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012721
—
TX
Enumeration date
06/17/2006
Last updated
02/13/2020
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