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Organization
DIVINE AT HILLSBORO ST INC.
Active
Organization
DIVINE AT HILLSBORO ST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS O ISIJOLA ADMINISTRATOR (OWNER/PRESIDENT)
(919) 880-4619
Entity
Organization
Contact information
Practice address
502 N HILLSBORO ST, YOUNGSVILLE, NC 27596-7779
(919) 880-4619
Mailing address
502 N HILLSBORO ST, YOUNGSVILLE, NC 27596-7779
(919) 880-4619
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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