Provider Demographics
NPI:1679108757
Name:DIVINE INTERVENTION CONSULTING
Entity type:Organization
Organization Name:DIVINE INTERVENTION CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGING PARTNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:ELYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-457-9203
Mailing Address - Street 1:1145 TERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-1747
Mailing Address - Country:US
Mailing Address - Phone:504-457-9203
Mailing Address - Fax:
Practice Address - Street 1:4110 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-6008
Practice Address - Country:US
Practice Address - Phone:504-457-9516
Practice Address - Fax:504-949-5537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN141638OtherREGISTERED NURSE