Organization
DEVINE PROVIDENCE HOME LLC
Active
Organization
DEVINE PROVIDENCE HOME LLC
Active
Other names
DEVINE PROVIDENCE HOME LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA TUEDJO FEGAING (DIRECTOR/MANAGER)
(682) 375-3968
Entity
Organization
Contact information
Practice address
3025 BLUE JAY LN, MIDLOTHIAN, TX 76065-8705
(682) 375-3968
Mailing address
3025 BLUE JAY LN, MIDLOTHIAN, TX 76065-8705
(682) 375-3968
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
12/06/2021
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