Organization
DIVINE PURPOSE LEGACY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DOREST (OWNER)
(704) 606-5240
Entity
Organization
Contact information
Practice address
8222 GABON CT, CHARLOTTE, NC 28215-7625
(704) 606-5240
Mailing address
9600 PERIMETER STATION DR APT 405, CHARLOTTE, NC 28216-4387
(704) 606-5240
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/05/2026
Last updated
03/05/2026
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