# DESTINY'S HOUSE INTENSIVE IN-HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144554007
- **Legal business name:** DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC
- **Authorized official:** MS. PATRICE MUHAMMAD (OFFICE MANAGER)
- **Authorized official phone:** (757) 706-3382

## Contact information

- **Practice address:** 6060 JEFFERSON AVE, STE 9003, NEWPORT NEWS, VA 23605-3014
- **Practice address phone:** (757) 706-3382
- **Practice address fax:** (757) 706-3383
- **Mailing address:** 6060 JEFFERSON AVE, STE 9003, NEWPORT NEWS, VA 23605-3014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 990 | VA | Yes |

## Other

- **Enumeration date:** 09/25/2009
- **Last updated:** 09/25/2009