Organization
DIVINE GUIDANCE INTEGRATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY WARD (DIRECTOR)
(252) 714-9056
Entity
Organization
Contact information
Practice address
1306 DUSK CT, GREENVILLE, NC 27834-7785
(252) 830-1802
(252) 695-6026
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
Primary
MHL-074-184
NC
Other
Enumeration date
05/15/2007
Last updated
07/31/2007
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