Organization
DIVINE INTERVENTION RECOVERY CENTER, LLC
Active
Other names
Divine Intervention Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
FAYETTA BARRON LISW-S (DIRECTOR OF CLINICAL SERVICES)
(937) 862-0008
Entity
Organization
Contact information
Practice address
7373 DAYTON SPRINGFIELD RD, ENON, OH 45323-1462
(937) 862-0008
Mailing address
7373 DAYTON SPRINGFIELD RD, ENON, OH 45323-1462
(937) 862-0008
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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