Healthcare Provider Details

I. General information

NPI: 1932937604
Provider Name (Legal Business Name): DEVINE HEALTHY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 VANDIFORD THOMAS RD
SNOW HILL NC
28580-7468
US

IV. Provider business mailing address

687 MOORE ROUSE RD
SNOW HILL NC
28580-7383
US

V. Phone/Fax

Practice location:
  • Phone: 252-419-2407
  • Fax:
Mailing address:
  • Phone: 252-419-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SIERRA JONES
Title or Position: OWNER
Credential:
Phone: 919-648-5782