A-Divine Residential Solutions

NPI #1568746659 in Longview, Texas

Provider Information

NPI Number: 1568746659
Entity Type: Organization
Organization Name: A-Divine Residential Solutions
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Oct 6, 2011
Last Updated: Oct 6, 2011

Practice Location

Address: 505 WOODWAY LN
City: Longview
State: Texas
ZIP Code: 75605-1535
Phone: (903) 315-8542

Authorized Official

Name: MRS. SHERRI FLUELLEN
Title: ADMINISTRATOR
Phone: (903) 315-8542

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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