Organization
DIVINE WELLNESS HOME HEALTH LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REMONICA LASHA WALLER (OWNER/ ADMINISTRATOR)
(945) 289-5483
Entity
Organization
Contact information
Practice address
1501 LAKE GROVE DR, LITTLE ELM, TX 75068-8655
(945) 289-5483
Mailing address
1501 LAKE GROVE DR, LITTLE ELM, TX 75068-8655
(469) 628-3606
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
07/18/2024
Last updated
04/07/2026
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