DIVINE PRODIGY LLC

HENDERSON, NC
NPI1598997959
Entity TypeOrganization
Authorized ContactNIKKITRA SHYVONNE WILLIAMS
Owner
252-431-9115
Organization Subpart ?No
Primary Taxonomy320800000X Community Based Residential Treatment Facility, Mental Illness
(Licence: NC  194)
Enumeration Date2009-08-19
Last Update Date2009-09-02
Business Address
DIVINE PRODIGY LLC
117 CHURCH ST 115 CARMEL RIDGE RD
HENDERSON, NC 27536-4226
Phone number: 252-431-9115
Mailing Address
DIVINE PRODIGY LLC
PO BOX 2191
HENDERSON, NC 27536-2191
Phone number: 252-431-9115
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