Organization
DESTINY HOUSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDIDIONG UDONKANG (PRESIDENT)
(708) 663-4910
Entity
Organization
Contact information
Practice address
18019 DIXIE HWY STE 1A, HOMEWOOD, IL 60430-3058
(708) 663-4910
Mailing address
18019 DIXIE HWY STE 1A, HOMEWOOD, IL 60430-3058
(708) 663-4910
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201700004
IL
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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