Organization
DIVINE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISICHEI SAMUEL ANENE (PROGRAM MANAGER)
(907) 351-4814
Entity
Organization
Contact information
Practice address
3906 PEBBLE HEIGHTS LN # TX77479, SUGAR LAND, TX 77479-3753
(907) 351-4814
Mailing address
3906 PEBBLE HEIGHTS LN # TX77479, SUGAR LAND, TX 77479-3753
(907) 351-4814
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
11/01/2023
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