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Organization

DIVINE FAMILY CARE HOME III INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRIS O ISIJOLA (OWNER/PRESIDENT)
(919) 880-4619
Entity
Organization

Contact information

Practice address
45 CANNADY WAY, FRANKLIN, NC 27525-8939
(919) 880-4619
Mailing address
45 CANNADY WAY, FRANKLIN, NC 27525-8939

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
10/29/2010
Last updated
10/29/2010
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