Provider Demographics
NPI:1083589972
Name:DIVINE NEEDS ASSISTED LIVING LLC
Entity type:Organization
Organization Name:DIVINE NEEDS ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:GABRIAEL
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:810-875-6309
Mailing Address - Street 1:245 E LORADO AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-2162
Mailing Address - Country:US
Mailing Address - Phone:810-875-6309
Mailing Address - Fax:810-422-5217
Practice Address - Street 1:245 E LORADO AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-2162
Practice Address - Country:US
Practice Address - Phone:810-875-6309
Practice Address - Fax:810-422-5217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health