Organization
DIVINE DESTINY ADULT CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATRINA BOYLAN (EXECUTIVE DIRECTOR)
(919) 934-7144
Entity
Organization
Contact information
Practice address
612 POWELL ST, SMITHFIELD, NC 27577-3118
(919) 934-7144
(877) 778-8178
Mailing address
612 POWELL ST, SMITHFIELD, NC 27577-3118
(919) 934-7144
(877) 778-8178
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2012
Last updated
06/26/2024
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