Provider Demographics
NPI:1497313571
Name:DIVINE BY DESIGN MENTORING CO
Entity Type:Organization
Organization Name:DIVINE BY DESIGN MENTORING CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-346-2488
Mailing Address - Street 1:12474 TURTLE DOVE PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1402
Mailing Address - Country:US
Mailing Address - Phone:301-346-2488
Mailing Address - Fax:
Practice Address - Street 1:12474 TURTLE DOVE PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1402
Practice Address - Country:US
Practice Address - Phone:301-346-2488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management