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Organization

MAGGIE'S DIVINE HOMES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ONORIODE PAULINE IGHOFOSE MD (MEMBER)
(347) 480-2110
Entity
Organization

Contact information

Practice address
13919 LITTLEBORNE BIRDWELL LN, HOUSTON, TX 77047-4530
(347) 480-2110
Mailing address
13919 LITTLEBORNE BIRDWELL LN, HOUSTON, TX 77047-4530
(347) 480-2110

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
09/19/2022
Last updated
07/18/2023
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