Provider Demographics
NPI:1053662908
Name:DIVINE HEALERS INC
Entity type:Organization
Organization Name:DIVINE HEALERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AFOLAKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYODELE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:713-818-1290
Mailing Address - Street 1:24919 GINGER RANCH DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5277
Mailing Address - Country:US
Mailing Address - Phone:713-818-1290
Mailing Address - Fax:281-392-9876
Practice Address - Street 1:24919 GINGER RANCH DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5277
Practice Address - Country:US
Practice Address - Phone:713-818-1290
Practice Address - Fax:281-392-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health