| Divine Behavioral Solutions | |
|
830 Mayfield St Taylorsville MS 39168 | |
| (601) 421-5034 | |
| Not Available |
| Full Name | Divine Behavioral Solutions |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 830 Mayfield St, Taylorsville, Mississippi |
| Authorized Official Name and Position | Patrick Surrell (OWNER) |
| Authorized Official Contact | 6014215034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Behavioral Solutions Po Box 17552 Hattiesburg MS 39404-7552 Ph: () - | Divine Behavioral Solutions 830 Mayfield St Taylorsville MS 39168 Ph: (601) 421-5034 |
| NPI Number | 1134952864 |
|---|---|
| Provider Enumeration Date | 08/20/2024 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134952864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Divine Behavioral Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 Mayfield St, Taylorsville, MS 39168 Phone: 601-421-5034 |