Organization
DIVINE HEALTH PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL A GBALA (CLINICAL DIRECTOR)
(443) 244-1221
Entity
Organization
Contact information
Practice address
117 E CHERRY HILL RD, REISTERSTOWN, MD 21136-3023
(443) 244-1221
Mailing address
117 E CHERRY HILL RD, REISTERSTOWN, MD 21136-3023
(443) 244-1221
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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