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Organization
DESTINY TREATMENT CENTER LLC
Active
Organization
DESTINY TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA RAE EDWARDS CATC (CEO)
(424) 342-1403
Entity
Organization
Contact information
Practice address
5230 CLARK AVE #31, LAKEWOOD, CA 90712
(424) 342-1403
(424) 287-0172
Mailing address
38 PARADISE VALLEY NORTH, CARSON, CA 90745
(424) 342-1403
(424) 287-0172
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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