Divine Intervention Recovery Center, LLC

NPI #1093430126 in Enon, Ohio

Provider Information

NPI Number: 1093430126
Entity Type: Organization
Organization Name: Divine Intervention Recovery Center, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: DIVINE INTERVENTION RECOVERY CENTER LLC
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Oct 11, 2022
Last Updated: Oct 11, 2022

Practice Location

Address: 7373 DAYTON SPRINGFIELD RD
City: Enon
State: Ohio
ZIP Code: 45323-1462
Phone: (937) 862-0008

Authorized Official

Name: FAYETTA BARRON, LISW-S
Title: DIRECTOR OF CLINICAL SERVICES
Phone: (937) 797-1926

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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