Organization
DIVINE CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACKIE ANTONIO PARKER (OWNER)
(252) 717-2169
Entity
Organization
Contact information
Practice address
500 C DEXTER STREET, GREENVILLE, NC 27834-5302
(252) 215-2273
Mailing address
3709 LIVE OAK LN, GREENVILLE, NC 27858-4152
(252) 717-2169
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/29/2009
Last updated
10/22/2011
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