Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Divine Prodigy LLC

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1598997959

Divine Prodigy LLC is a Mental Illness Community Based Residential Treatment Facility in Henderson, North Carolina. Licensed in North Carolina. Registered with an NPI since 2009.

Licensed in
NC
In the registry since
2009
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

117 Church St 115 Carmel Ridge Rd
Henderson, NC 27536-4226
Phone: (252) 431-9115
Fax: (252) 438-6140
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X · Licence 194 (NC)

Record details

NPI number1598997959
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nikkitra Williams — Owner · (252) 431-9115
NPI enumeratedAugust 19, 2009
Last updated in NPPESSeptember 2, 2009
Mailing addressPo Box 2191, Henderson, NC 27536-2191

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