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Organization
DESTINY'S HOUSE INTENSIVE IN-HOME
Active
Organization
DESTINY'S HOUSE INTENSIVE IN-HOME
Active
Parent organization
DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC
Authorized official
MS. PATRICE MUHAMMAD (OFFICE MANAGER)
(757) 706-3382
Entity
Organization
Contact information
Practice address
6060 JEFFERSON AVE, STE 9003, NEWPORT NEWS, VA 23605-3014
(757) 706-3382
(757) 706-3383
Mailing address
6060 JEFFERSON AVE, STE 9003, NEWPORT NEWS, VA 23605-3014
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
990
VA
Other
Enumeration date
09/25/2009
Last updated
09/25/2009
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