Organization
DIVINE LIGHT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SAKINA DEAN (EXECUTIVE DIRECTOR)
(267) 278-1079
Entity
Organization
Contact information
Practice address
25 SHARPNACK STREET, PHILADELPHIA, PA 19119
(267) 278-1079
Mailing address
2211 MARYLAND AVE, BALTIMORE, MD 21218-5627
(267) 278-1079
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/10/2017
Last updated
07/11/2022
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