| Organization Name: | DIVINE HOSPICE INC |
| NPI Number: | 1285679118 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONSOLOTA BRYANT (ADMINISTRATOR) |
| Mailing Address: | 345 Westpark Way #101 Euless |
| State: | TX US |
| Postal Code: | 760403913 |
| Phone Number: | 8172681946 |
| Fax Number: | 8172680209 |
| NPI Enumeration Date: | 06/17/2006 |
| NPI Last Update Date: | 04/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 008914 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |