| Divine Intervention Treatment Facility LLC | |
|
5665 6th St Violet LA 70092-3040 | |
| (504) 415-9371 | |
| Not Available |
| Full Name | Divine Intervention Treatment Facility LLC |
|---|---|
| Speciality | Rehabilitation, Substance Use Disorder Unit |
| Location | 5665 6th St, Violet, Louisiana |
| Authorized Official Name and Position | Terione Monique Brock (OWNER/MANAGER) |
| Authorized Official Contact | 5044159371 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Intervention Treatment Facility LLC Po Box 259 Violet LA 70092-0259 Ph: (504) 415-9371 | Divine Intervention Treatment Facility LLC 5665 6th St Violet LA 70092-3040 Ph: (504) 415-9371 |
| NPI Number | 1699274860 |
|---|---|
| Provider Enumeration Date | 02/02/2018 |
| Last Update Date | 02/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699274860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Secondary |
| 276400000X | Rehabilitation, Substance Use Disorder Unit | () | Primary |
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