| Divine Destiny Adult Care Inc. | |
|
612 Powell St Smithfield NC 27577-3118 | |
| (919) 934-7144 | |
| (877) 778-8178 |
| Full Name | Divine Destiny Adult Care Inc. |
|---|---|
| Speciality | Clinic/center - Adult Day Care |
| Location | 612 Powell St, Smithfield, North Carolina |
| Authorized Official Name and Position | Katrina Boylan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9199347144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Destiny Adult Care Inc. 612 Powell St Smithfield NC 27577-3118 Ph: (919) 934-7144 | Divine Destiny Adult Care Inc. 612 Powell St Smithfield NC 27577-3118 Ph: (919) 934-7144 |
| NPI Number | 1740537489 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740537489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QA0600X | Clinic/center - Adult Day Care | (* (Not Available)) | Primary |
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