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General NPI Number Information
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NPI Number | 1598612764
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Entity Type | Organization
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Legal Business Name | DIVINEQUEST CORPORATION
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 130 BIRCH ST
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City | HIRAM
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State | GA
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Zip | 30141
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Country | US
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Telephone | 770-367-5357
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Fax |
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Provider Business Mailing Address
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Address Line | 130 BIRCH ST
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City | HIRAM
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State | GA
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Zip | 30141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN CASE MANAGER
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Name | KIZZIE ENOCH
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Credential |
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Telephone | 770-367-5357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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