| Divine Revitalization Management Incorporated | |
|
102 Trailwood Dr Dudley NC 28333-9466 | |
| (919) 330-4601 | |
| (919) 330-4601 |
| Full Name | Divine Revitalization Management Incorporated |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 102 Trailwood Dr, Dudley, North Carolina |
| Authorized Official Name and Position | Rochelle Nicole Herring (OWNER) |
| Authorized Official Contact | 9193962586 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Revitalization Management Incorporated 205 Deluca Rd Goldsboro NC 27534-4417 Ph: (919) 751-1254 | Divine Revitalization Management Incorporated 102 Trailwood Dr Dudley NC 28333-9466 Ph: (919) 330-4601 |
| NPI Number | 1750521027 |
|---|---|
| Provider Enumeration Date | 02/26/2009 |
| Last Update Date | 02/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750521027 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL-096-218 (North Carolina) | Primary |
Wayne Initiative For School Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3761 Us Hwy 117 South, Dudley, NC 28333 Phone: 919-751-9120 | |
House For Margaret Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Rollingwood Dr, Dudley, NC 28333 Phone: 919-731-9815 |