Organization
DIVINE GRACE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANBENA EMETO (ADMINISTRATOR)
(919) 370-0860
Entity
Organization
Contact information
Practice address
5633 QUITMAN TRL, RALEIGH, NC 27610-6475
(919) 370-0860
Mailing address
5633 QUITMAN TRL, RALEIGH, NC 27610-6475
(919) 370-0860
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200433
—
NC
Enumeration date
08/31/2020
Last updated
08/31/2020
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