Organization
DIVINE REVITALIZATION MANAGEMENT INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROCHELLE NICOLE HERRING BS (OWNER)
(919) 396-2586
Entity
Organization
Contact information
Practice address
102 TRAILWOOD DR, DUDLEY, NC 28333-9466
(919) 330-4601
(919) 330-4601
Mailing address
205 DELUCA RD, GOLDSBORO, NC 27534-4417
(919) 751-1254
(919) 751-1254
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-096-218
NC
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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