Organization
FLORENCE BENNETT
Active
Other names
DIVINITY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
FLORENCE N BENNETT (PROGRAM DIRECTOR)
(713) 303-1325
Entity
Organization
Contact information
Practice address
6111 WILCREST DR, HOUSTON, TX 77072
(713) 303-1325
(713) 303-1325
Mailing address
5800 RANCHESTER DR STE 188, HOUSTON, TX 77036-2464
(713) 303-1325
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
311ZA0620X
Adult Care Home Facility
—
TX
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
001007690
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700965167
—
TX
Enumeration date
06/23/2017
Last updated
05/09/2019
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