Organization
DESTINY HOME, INC. #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSWALD NWOGBO (CEO)
(919) 454-7725
Entity
Organization
Contact information
Practice address
1708 VINTAGE RD, RALEIGH, NC 27610-3187
(919) 454-7725
(919) 231-3736
Mailing address
234 SEVEN OAKS RD, DURHAM, NC 27704-1125
(919) 454-7725
(919) 231-3736
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
MHL-032-487
NC
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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