| Daughter Of Destiny Enterprises,llc | |
|
941 Us Highway 64 E 1672 Long Ridge Rd Plymouth NC 27962-9216 | |
| (252) 661-1792 | |
| (252) 793-5022 |
| Full Name | Daughter Of Destiny Enterprises,llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 941 Us Highway 64 E, Plymouth, North Carolina |
| Authorized Official Name and Position | Jennifer Herlene Carmack (CEO) |
| Authorized Official Contact | 2526611792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daughter Of Destiny Enterprises,llc 941 Us Highway 64 E 1672 Long Ridge Rd Plymouth NC 27962-9216 Ph: (252) 661-1792 | Daughter Of Destiny Enterprises,llc 941 Us Highway 64 E 1672 Long Ridge Rd Plymouth NC 27962-9216 Ph: (252) 661-1792 |
| NPI Number | 1215100854 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 04/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215100854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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