Organization Name: | DIVINE CARE SERVICES |
NPI Number: | 1124298716 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUZANNE MASSEY (CEO) |
Mailing Address: | 2126 S Edward Ave Gonzales |
State: | LA US |
Postal Code: | 707373705 |
Phone Number: | 2257724950 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2008 |
NPI Last Update Date: | 08/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |