NPI 1194571299
Divine Network LLC
Practice location
- Address
- 315 E 5th St STE 202, Waterloo, IA 50703-4757
- Phone
- (515) 778-6814
Authorised official
- Name
- Ebiweni Ojeke
- Title
- Director
- Phone
- (515) 778-6814
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1194571299
- Entity type
- Organization
- NPI issued
- 29 Apr 2024
- Record last updated
- 29 Apr 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.