Divine Wellness Inc | |
9633 Liberty Rd Ste K Randallstown MD 21133-2435 | |
(443) 272-2207 | |
Not Available |
Full Name | Divine Wellness Inc |
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Speciality | Clinic/center - Adult Mental Health |
Location | 9633 Liberty Rd Ste K, Randallstown, Maryland |
Authorized Official Name and Position | Olusegun Adewale Sofowote (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4432722207 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Divine Wellness Inc 9633 Liberty Rd Ste K Randallstown MD 21133-2435 Ph: (443) 272-2207 | Divine Wellness Inc 9633 Liberty Rd Ste K Randallstown MD 21133-2435 Ph: (443) 272-2207 |
NPI Number | 1821656901 |
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Provider Enumeration Date | 06/03/2019 |
Last Update Date | 06/03/2019 |
Identifier | Type | State | Issuer |
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1821656901 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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