Divine Revitalization Management Incorporated

Organization Active NPI Adult Mental Health Clinic/Center · Dudley, NC

NPI 1750521027 · NPPES record last updated Feb 26, 2009

Key facts

NPI
1750521027
Entity type
Organization (NPI type 2)
Primary specialty
Adult Mental Health Clinic/Center 261QM0850X
License
MHL-096-218 (NC)
Legal business name
DIVINE REVITALIZATION MANAGEMENT INCORPORATED
Practice address
102 Trailwood Dr
Dudley, NC 28333-9466
Phone
(919) 330-4601
Fax
(919) 330-4601
NPI assigned
Feb 26, 2009
Organization subpart
No

Authorized official

Name
Ms. Rochelle Nicole Herring, BS
Title
Owner
Phone
(919) 396-2586

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL-096-218 NC Yes

Addresses

Primary practice location

102 Trailwood Dr
Dudley, NC 28333-9466

Mailing address

205 Deluca Rd
Goldsboro, NC 27534-4417
Phone (919) 751-1254

Other providers in Dudley, NC

All providers in Dudley, NC · Adult Mental Health Clinic/Center in North Carolina

Sources for this page

Verify at the official NPI Registry.