Provider Demographics
NPI:1366780934
Name:DEVINITY HOME HEALTH CARE PLLC
Entity type:Organization
Organization Name:DEVINITY HOME HEALTH CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUBANWO
Authorized Official - Middle Name:GINA
Authorized Official - Last Name:OMISANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-881-2782
Mailing Address - Street 1:9102 ASPEN TRACE LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2802
Mailing Address - Country:US
Mailing Address - Phone:281-570-4072
Mailing Address - Fax:281-570-6234
Practice Address - Street 1:9102 ASPEN TRACE LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2802
Practice Address - Country:US
Practice Address - Phone:281-570-4072
Practice Address - Fax:281-570-6234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
TX015585251E00000X, 251J00000X, 251S00000X, 251T00000X, 3747P1801X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty