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General NPI Number Information
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NPI Number | 1790678175
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Entity Type | Organization
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Legal Business Name | DIVINE INTERVENTION ENTERPRISES LLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1400 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-8042
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Country | US
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Telephone | 336-988-8844
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Fax | 336-285-5674
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Provider Business Mailing Address
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Address Line | 1400 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-8042
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Country | US
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Telephone | 336-988-8844
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Fax | 336-285-5674
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Authorized Official
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Title or Position | OWNER/PROGRAM DIRECTOR
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Name | DEENA M MOYE LIVINGSTON
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Credential | MH/SUD/IDD QP
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Telephone | 336-988-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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