| Divinity Sentiments Inc | |
|
4328 Clevemont Rd Ellenwood GA 30294-1329 | |
| (404) 212-9666 | |
| Not Available |
| Full Name | Divinity Sentiments Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4328 Clevemont Rd, Ellenwood, Georgia |
| Authorized Official Name and Position | Denise D Gatewood (CEO) |
| Authorized Official Contact | 7708983002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divinity Sentiments Inc 1064 Rowanshyre Cir Mcdonough GA 30253-2917 Ph: (770) 898-3002 | Divinity Sentiments Inc 4328 Clevemont Rd Ellenwood GA 30294-1329 Ph: (404) 212-9666 |
| NPI Number | 1477747244 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 04/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477747244 | NPI | - | NPPES |
| 805877657A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 000723 (Georgia) | Primary |
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