Divine Prodigy Llc

LBN: Divine Prodigy Llc
Divine Prodigy Llc is an health care organization with primary practice located at 117 Church St 115 Carmel Ridge Rd, Henderson NC 27536-4226. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Divine Prodigy Llc can be contacted via phone (252) 431-9115, or through Williams, Nikkitra Shyvonne via phone (252) 431-9115.

Contact Information

Primary practice address
117 Church St 115 Carmel Ridge Rd Henderson NC 27536-4226
Phone: (252) 431-9115
Fax: (252) 438-6140
Website:
Map and Directions
Authorized official contact:
Name: Williams, Nikkitra Shyvonne
Phone: (252) 431-9115

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 194 North Carolina

Profile Details

NPI number 1598997959
LBN Legal business name Divine Prodigy Llc
DBA Doing business as
Authorized official Williams, Nikkitra Shyvonne
Entity Organization
Organization subpart 1 No
Enumeration date Aug 19th, 2009
Last updated Sep 2nd, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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