Organization
DIVINE BEHAVIORAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK SURRELL (OWNER)
(601) 421-5034
Entity
Organization
Contact information
Practice address
830 MAYFIELD ST, TAYLORSVILLE, MS 39168
(601) 421-5034
Mailing address
PO BOX 17552, HATTIESBURG, MS 39404-7552
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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