Organization
DIVINE LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DASHAWN JAMAR MCGARY (DIRECTOR OF FINANCE)
(402) 213-8417
Entity
Organization
Contact information
Practice address
6657 SORENSEN PKWY, OMAHA, NE 68152-2139
(402) 315-3593
Mailing address
6657 SORENSEN PKWY, OMAHA, NE 68152-2139
(402) 315-3593
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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