Healthcare Provider Details

I. General information

NPI: 1770747933
Provider Name (Legal Business Name): DIVERSIFIED RISK MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 WARWICK DRIVE
PINETOPS NC
27864
US

IV. Provider business mailing address

106 MOORE RD
GREENVILLE NC
27834-6562
US

V. Phone/Fax

Practice location:
  • Phone: 252-367-1176
  • Fax: 252-757-1985
Mailing address:
  • Phone: 252-367-1176
  • Fax: 252-757-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. RENA FAY BUNNS-BATTLE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 252-367-1176