JEFFREY ALAN DIVINE

GRASS VALLEY, CA
NPI1568702520
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy322D00000X Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date2013-02-27
Last Update Date2013-02-27
Business Address
-- JEFFREY ALAN DIVINE
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
Mailing Address
-- JEFFREY ALAN DIVINE
714 W MAIN ST
GRASS VALLEY, CA 95945-6410
Phone number: 530-477-9800
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