Organization
DIVINE ASSISTED CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE IGBOWKE (ADMINSTRATOR)
(832) 788-0387
Entity
Organization
Contact information
Practice address
15502 EMPANADA DR, HOUSTON, TX 77083-4112
(832) 788-0387
Mailing address
15502 EMPANADA DR, HOUSTON, TX 77083-4112
(832) 788-0387
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
120466
TX
Other
Enumeration date
05/24/2007
Last updated
11/05/2007
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