Organization
DIVINE LEGENDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASITY DAVIS (OWNER)
(919) 348-6246
Entity
Organization
Contact information
Practice address
555 FAYETTEVILLE ST STE 201, RALEIGH, NC 27601-3034
(919) 348-6246
Mailing address
PO BOX 41071, RALEIGH, NC 27629-1071
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/17/2017
Last updated
06/16/2018
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