Provider Demographics
NPI:1033865886
Name:DIVINE TREASURE HOUSE
Entity Type:Organization
Organization Name:DIVINE TREASURE HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLORUNTOBA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:404-791-3060
Mailing Address - Street 1:1775 THE EXCHANGE SE STE 265
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2016
Mailing Address - Country:US
Mailing Address - Phone:404-791-3060
Mailing Address - Fax:
Practice Address - Street 1:3946 SAINT JOHNS AVE APT 1006
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-9499
Practice Address - Country:US
Practice Address - Phone:404-791-3060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities