Devine Home Health Agency Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

008474 Issued in TX

Legal business name

DEVINE HOME HEALTH AGENCY INC

Practice address

800 W. Airport Freeway
Suite 514
Irving, TX 75062

Phone

(972) 871-9152

Fax

(972) 871-9172

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Anthony Ejofor

Title

Owner

Phone

(972) 871-9152

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 679453

Legal name

DEVINE HOME HEALTH AGENCY INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 25, 2004

Last certification

Oct 25, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 6, 2003 in TX

Enrollment address

800 W Airport Freeway
Suite 514
Irving, TX 75062

Listed as

Devine Home Health Agency IncCCN 679453

Ownership

Proprietary

Certified

Mar 25, 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 4

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629160239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W. AIRPORT FREEWAY",
            "address_2": "SUITE 514",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-871-9152",
            "fax_number": "972-871-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W. AIRPORT FREEWAY",
            "address_2": "SUITE 514",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-871-9152",
            "fax_number": "972-871-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVINE HOME HEALTH AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EJOFOR",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-871-9152",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008474",
            "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 Aug 22, 2020; 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.