Organization
DIVINE BLESSINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GWENDOLYN CUFFEE MEDICAID PROVIDER (PRESIDENT)
(386) 252-9578
Entity
Organization
Contact information
Practice address
904 JEFFREY ST, DAYTONA BEACH, FL 32117-4215
(386) 252-9578
Mailing address
904 JEFFREY ST, DAYTONA BEACH, FL 32117-4215
(386) 252-9578
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
06-12-077
FL
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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