Organization
GOD'S DESTINY FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BROOKE AMELIA JORDAN (OWNER/ADMINISTRATOR)
(252) 567-7821
Entity
Organization
Contact information
Practice address
107 GREENWOOD AVE, ROCKY MOUNT, NC 27804-3739
(252) 443-3521
(252) 443-3521
Mailing address
100 BIRDIE CT, ROCKY MOUNT, NC 27804-8611
(252) 443-3521
(252) 443-3521
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
FCL-064-025
NC
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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