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Organization
DIVINE RESTORATION BEHAVIORAL HEALTH LLC
Active
Organization
DIVINE RESTORATION BEHAVIORAL HEALTH LLC
Active
Other names
Divine Restoration Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABDONNE MBOUADEU DNP (PMHNP-BC)
(774) 318-7893
Entity
Organization
Contact information
Practice address
98 LOWER WESTFIELD RD STE 101, HOLYOKE, MA 01040-2744
(774) 318-7893
Mailing address
98 LOWER WESTFIELD RD STE 101, HOLYOKE, MA 01040-2744
(774) 420-1993
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/10/2023
Last updated
08/15/2024
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