NPIMap

Organization Active NPI

Divine Guidance Integrative Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Greenville, NC
National Provider Identifier
1043365646
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-074-185 Issued in NC
Legal business name
DIVINE GUIDANCE INTEGRATIVE SERVICES
Practice address
202 S Warren St
Greenville, NC 27858-2721
Phone
(252) 752-0551
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jeffrey Ward
Title
Director
Phone
(252) 714-9056

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-074-181 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-074-184 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-074-185 NC Primary

Addresses

Primary practice location

202 S Warren St
Greenville, NC 27858-2721

Mailing address

2317 Executive Cir
Suite B
Greenville, NC 27834-3762
Phone (252) 695-6040

Other identifiers 4

IdentifierTypeStateIssuer
6604166MedicaidNC
6604167MedicaidNC
6604099MedicaidNC
8301931BMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Divine Guidance Integrative Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1043365646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 EXECUTIVE CIR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343762",
            "telephone_number": "252-695-6040",
            "fax_number": "252-695-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S WARREN ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278582721",
            "telephone_number": "252-752-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE GUIDANCE INTEGRATIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-714-9056",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-074-181",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-074-184",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-074-185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604166",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604167",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604099",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301931B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.