Organization
DIVINE WORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY PETERKIN (CASE MANAGER SUPERVISOR)
(757) 779-4493
Entity
Organization
Contact information
Practice address
4100 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23452-1744
(757) 779-4493
Mailing address
5735 E HASTINGS ARCH, VIRGINIA BEACH, VA 23462-1506
(757) 779-4493
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102368
VA
Other
Enumeration date
05/08/2015
Last updated
05/08/2015
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