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Organization

DIVINE FAMILY CARE HOME

Active
Organization subpart
No

Provider details

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

Contact information

Practice address
113 JUSTICE ST, LOUISBURG, NC 27549-2331
(919) 853-2700
(919) 853-7527
Mailing address
113 JUSTICE ST, LOUISBURG, NC 27549-2331
(919) 853-2700
(919) 853-7527

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
035019
NC

Other

Enumeration date
11/30/2007
Last updated
11/30/2007
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