Divine Home Health Agency, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

DIVINE HOME HEALTH AGENCY, LLC

Practice address

2700 W Pleasant Run Rd Ste 380
Lancaster, TX 75146-1016

Phone

(214) 221-0790

Fax

(972) 685-7898

NPI assigned

Jun 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Calista Ikwuakolam

Title

Cfo

Phone

(214) 221-0790

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 679401

Legal name

DIVINE HOME HEALTH AGENCY, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 2, 2004

Last certification

Oct 24, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 22, 2003 in TX

Enrollment address

2700 W Pleasant Run Road
Suite 380
Lancaster, TX 75146

Listed as

Divine Home Health Agency LLCCCN 679401

Ownership

Proprietary

Certified

Jan 2, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1013951136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W PLEASANT RUN RD STE 380",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461016",
            "telephone_number": "214-221-0790",
            "fax_number": "972-685-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W PLEASANT RUN RD STE 380",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461016",
            "telephone_number": "214-221-0790",
            "fax_number": "972-685-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOME HEALTH AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "IKWUAKOLAM",
        "authorized_official_first_name": "CALISTA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "214-221-0790"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "679401",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.