| Destiny Home, Inc. #2 | |
|
1708 Vintage Rd Raleigh NC 27610-3187 | |
| (919) 454-7725 | |
| (919) 231-3736 |
| Full Name | Destiny Home, Inc. #2 |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1708 Vintage Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Oswald Nwogbo (CEO) |
| Authorized Official Contact | 9194547725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Home, Inc. #2 234 Seven Oaks Rd Durham NC 27704-1125 Ph: (919) 454-7725 | Destiny Home, Inc. #2 1708 Vintage Rd Raleigh NC 27610-3187 Ph: (919) 454-7725 |
| NPI Number | 1295965473 |
|---|---|
| Provider Enumeration Date | 07/21/2009 |
| Last Update Date | 07/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295965473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | MHL-032-487 (North Carolina) | Primary |
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