| NPI | 1043766371 |
|---|---|
| Doing Business As | DIVINE INTERVENTION RECOVERY |
| Entity Type | Organization |
| Authorized Contact | SHARON LYNETTE JACKSON CEO 951-591-0362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |