Organization
DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE
Active
Parent organization
DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE
Other names
divine grace in-home & private healthcare service
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVINE GRACE IN-HOME & PRIVATE HEALTHCARE SERVICE
Authorized official
DAVID JR GRIFFIN (OWNER)
(919) 796-0734
Entity
Organization
Contact information
Practice address
3535 S WILMINGTON ST STE 202, 3535 SOUTH WILMINGTON STREET SUITE 202, RALEIGH, NC 27603-3512
(919) 796-0734
Mailing address
3535 S WILMINGTON ST STE 202, SUITE 202, RALEIGH, NC 27603-3512
(919) 796-0734
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4729
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150081
—
NC
Enumeration date
02/19/2015
Last updated
02/19/2015
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