Organization
DEVINE CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL C NDUKWE (PROGRAM DIRECTOR)
(832) 526-0193
Entity
Organization
Contact information
Practice address
6019 ACORN VALLEY LN, RICHMOND, TX 77469-6241
(832) 526-0193
Mailing address
6019 ACORN VALLEY LN, RICHMOND, TX 77469-6241
(832) 526-0193
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
TX
253J00000X
Foster Care Agency
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092461
MEDICAID
TX
Enumeration date
07/12/2018
Last updated
07/12/2018
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