Organization
DIVINE CONNECTION OF DURHAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARINE FULLER (SOLE MEMBER)
(919) 806-1300
Entity
Organization
Contact information
Practice address
3201 YORKTOWN AVE STE 107, DURHAM, NC 27713-1474
(919) 949-8835
Mailing address
3201 YORKTOWN AVE STE 107, DURHAM, NC 27713-1474
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/16/2009
Last updated
06/18/2009
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