Organization
DIVINE GUIDANCE INTEGRATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY WARD (DIRECTOR)
(252) 714-9056
Entity
Organization
Contact information
Practice address
202 S WARREN ST, GREENVILLE, NC 27858-2721
(252) 752-0551
Mailing address
2317 EXECUTIVE CIR, SUITE B, GREENVILLE, NC 27834-3762
(252) 695-6040
(252) 695-6026
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
MHL-074-185
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604099
—
NC
05
—
6604166
—
NC
05
—
6604167
—
NC
05
—
8301931B
—
NC
Enumeration date
01/24/2007
Last updated
07/17/2007
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