Organization
DESTINY CARE
Active
Other names
Destiny Care
Organization subpart
No
Provider details
NPI number
Authorized official
DANYELL RUSSELL (OWNER)
(901) 493-0808
Entity
Organization
Contact information
Practice address
3232 RIVER VALLEY LN, MEMPHIS, TN 38119-8090
(901) 493-0808
Mailing address
3232 RIVER VALLEY LN, MEMPHIS, TN 38119-8090
(901) 493-0808
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000000031843
LICENSE NUMBER
TN
Enumeration date
11/09/2022
Last updated
01/17/2023
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