Organization
DIVINE BEHAVIORAL SERVICES
Active
Organization
DIVINE BEHAVIORAL SERVICES
Active
Other names
One Community Behavioral Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMAUL GODDARD (CEO)
(770) 234-9667
Entity
Organization
Contact information
Practice address
3781 PRESIDENTIAL PKWY, SUITE 110, ATLANTA, GA 30340-3702
(770) 234-9667
(770) 234-9668
Mailing address
3781 PRESIDENTIAL PKWY, SUITE 110, ATLANTA, GA 30340-3702
(770) 234-9667
(770) 234-9668
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003160059A
—
GA
Enumeration date
08/26/2015
Last updated
08/26/2015
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