Organization
DESTINY 360 RESIDENTIAL SERVICES. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER MONROE (PRESIDENT)
(336) 210-2304
Entity
Organization
Contact information
Practice address
1811 SILVER CITY ST, RAEFORD, NC 28376-8605
(919) 479-1505
Mailing address
PO BOX 25395, FAYETTEVILLE, NC 28314-5006
(910) 479-1505
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
09/04/2024
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