# DIVERSE WELLNESS SOLUTIONS INC

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

## Provider details

- **NPI number:** 1912299173
- **Authorized official:** MRS. KIMBALL JANE-MARIE SARGENT MSN, PMHCNS-BC (OWNER/PRESIDENT)
- **Authorized official phone:** (919) 838-0804

## Contact information

- **Practice address:** 7155 SUNSET LAKE RD, FUQUAY VARINA, NC 27526-8638
- **Practice address phone:** (919) 838-0804
- **Practice address fax:** (919) 838-1219
- **Mailing address:** 7155 SUNSET LAKE RD, FUQUAY VARINA, NC 27526-8638
- **Mailing address phone:** (919) 838-0804
- **Mailing address fax:** (919) 838-1219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | 0261495-01 | NC | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 0261495-01 | NC | — |
| 364SP0808X | Psychiatric/Mental Health Clinical Nurse Specialist | 0261495-01 | NC | Yes |

## Other

- **Enumeration date:** 05/06/2011
- **Last updated:** 01/06/2016