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Organization
DIVINE CARE HOME
Active
Organization
DIVINE CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLANDA CERISIERS RN (ADMINISTRATOR)
(239) 350-8201
Entity
Organization
Contact information
Practice address
429 CROCKER RD, KINGS MOUNTAIN, NC 28086-4004
(239) 350-8201
(704) 734-5967
Mailing address
429 CROCKER RD, KINGS MOUNTAIN, NC 28086-4004
(239) 350-8201
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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