# DIVINE GUIDANCE INTEGRATIVE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043365646
- **Authorized official:** MR. JEFFREY WARD (DIRECTOR)
- **Authorized official phone:** (252) 714-9056

## Contact information

- **Practice address:** 202 S WARREN ST, GREENVILLE, NC 27858-2721
- **Practice address phone:** (252) 752-0551
- **Mailing address:** 2317 EXECUTIVE CIR, SUITE B, GREENVILLE, NC 27834-3762
- **Mailing address phone:** (252) 695-6040
- **Mailing address fax:** (252) 695-6026

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-074-181 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-074-184 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-074-185 | NC | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 07/17/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6604099 | — | NC |
| 05 | — | 6604166 | — | NC |
| 05 | — | 6604167 | — | NC |
| 05 | — | 8301931B | — | NC |