Organization
GODS DIVINE PURPOSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR EARL BLACKWELL (DIRECTOR)
(336) 420-7893
Entity
Organization
Contact information
Practice address
3437 SHEPHERD RD TRLR 42, ELON, NC 27244-7553
(336) 420-7893
Mailing address
3437 SHEPHERD RD TRLR 42, ELON, NC 27244-7553
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-001190
NC
Other
Enumeration date
01/18/2010
Last updated
01/18/2010
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