MEDICARE: DIVINE TOUCH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103TR0400X	Rehabilitation Psychologist
3	104100000X	Social Worker
4	106H00000X	Marriage & Family Therapist
5	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134498264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE TOUCH INC

Provider Business Mailing Address
First Line	:	1828 ARCH STONE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5095
Country	:	US
Telephone Number	:	702-787-2116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 ARCH STONE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-5095
Country	:	US
Telephone Number	:	702-787-2116
Fax Number	:

Authorized Official
Title or Position	:	CEO & PRESIDENT
Name	:	MS. SHINEKA C FOY
Credential	:
Telephone Number	:	702-787-2116

Provider Enumeration Date	:	12/19/2011
Last Update Date	:	12/19/2011

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Directions to “DIVINE TOUCH INC ” Practice Location

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