Organization
DIVINE RECOVERY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA BURGE (CEO)
(919) 529-0325
Entity
Organization
Contact information
Practice address
2775 CLIFTON AVE, CREEDMOOR, NC 27522-9511
(919) 529-0325
Mailing address
2775 CLIFTON AVE, CREEDMOOR, NC 27522-9511
(919) 529-0325
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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