Organization
DIVINE ACCESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UDU OLADEINDE (MANAGER)
(770) 983-4048
Entity
Organization
Contact information
Practice address
167 GILLIFLOWER PARK, SUWANEE, GA 30024-6456
(770) 983-4084
Mailing address
990 PEACHTREE INDUSTRIAL BLVD, P.O.BOX 938, SUWANEE, GA 30024-9998
(770) 983-4048
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/25/2024
Last updated
06/02/2024
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