A Greater Divine Place Inc

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

029098 Issued in NC

Legal business name

A GREATER DIVINE PLACE INC

Practice address

366 Bremen Garden Dr
Lexington, NC 27295-6044

Phone

(336) 484-8022

NPI assigned

Jan 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Darin Griffin

Title

Owner Ceo

Phone

(336) 239-4312

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174675623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAMILTON RD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272951831",
            "telephone_number": "336-239-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 BREMEN GARDEN DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272956044",
            "telephone_number": "336-484-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A GREATER DIVINE PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DARIN",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "336-239-4312"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "029098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Lexington, NC
• Providers in Lexington, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.