Provider Demographics
NPI:1376249334
Name:DIVINE BEGINNINGS WV, LLC
Entity Type:Organization
Organization Name:DIVINE BEGINNINGS WV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM, APRN, FACNM
Authorized Official - Phone:304-616-7718
Mailing Address - Street 1:31500 MIDLAND TRL
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT
Mailing Address - State:WV
Mailing Address - Zip Code:25868-6208
Mailing Address - Country:US
Mailing Address - Phone:304-616-7718
Mailing Address - Fax:973-604-4230
Practice Address - Street 1:137 1/2 MAIN ST E
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3032
Practice Address - Country:US
Practice Address - Phone:304-616-7718
Practice Address - Fax:973-604-4232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service