OrganizationActive
Empowerment of Divine Providence, Inc.
NPI 1295017382 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Dallas, GA
Provider details
- NPI number
- 1295017382
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Clorissal Liu, Owner
Mailing address
3 Birchfield Way
Dallas, GA 30132-0842
Registry dates
- Enumerated
- 2011-09-14
- Last updated
- 2014-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.