Organization
DIVINE LIFE INSTITUTE LLC
Active
Other names
Divine Life Institute LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE BELIZAIRE (OWNER)
(978) 381-9007
Entity
Organization
Contact information
Practice address
75 ARLINGTON ST STE 500, BOSTON, MA 02116-3936
(978) 381-9007
(855) 420-6895
Mailing address
500 N RAINBOW BLVD STE 300, LAS VEGAS, NV 89107-1061
(978) 540-5222
(185) 542-0689
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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