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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