# DIVINE INTERVENTION TREATMENT FACILITY LLC

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

## Provider details

- **NPI number:** 1699274860
- **Authorized official:** TERIONE MONIQUE BROCK (OWNER/MANAGER)
- **Authorized official phone:** (504) 415-9371

## Contact information

- **Practice address:** 5665 6TH ST, VIOLET, LA 70092-3040
- **Practice address phone:** (504) 415-9371
- **Mailing address:** PO BOX 259, VIOLET, LA 70092-0259
- **Mailing address phone:** (504) 415-9371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 276400000X | Substance Use Disorder Rehabilitation Hospital Unit | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2018
- **Last updated:** 02/02/2018