Divine Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

016265 Issued in TX

Legal business name

DIVINE CARE

Practice address

215 Executive Way
130
Desoto, TX 75115-2396

Phone

(972) 947-3100

Fax

(972) 947-3099

NPI assigned

Oct 1, 2015

Organization subpart

No

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

Authorized official

Name

Mercedes McQueen

Title

Administrator

Phone

(817) 412-3956

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Divine Care Other name

Locations

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1619347705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 EXECUTIVE WAY",
            "address_2": "130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152396",
            "telephone_number": "972-947-3100",
            "fax_number": "972-947-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 EXECUTIVE WAY",
            "address_2": "130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152396",
            "telephone_number": "972-947-3100",
            "fax_number": "972-947-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "MCQUEEN",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-412-3956"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "016265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED HOME HEALTH SERVICES, PERSONAL CARE SERVICES",
            "identifier": "016265",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Divine Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christian Diaz
• Tiffani Dickerson, RN-IBCLC
• Digitrace Care Services, Inc.
• Lavonda Dillard, FNP
• Divine Boyd Enterprise LLC
• Divine Heritage Health Home Care Agency LLC
• Catherine L Dixon, NP
• DLB Pharmacy LLC
• Donald G Nicholas Jr MD
• Jacqueline Dorsey

• Home Health Agency in Desoto, TX
• Providers in Desoto, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.