Organization
ENHANCED DESTINY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ELLIS (HUMAN RESOURCES)
(504) 373-6877
Entity
Organization
Contact information
Practice address
406 RAYBURN RD, CARRIERE, MS 39426-8381
(601) 590-6526
Mailing address
406 RAYBURN RD, CARRIERE, MS 39426-8381
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
04/12/2017
Last updated
07/21/2022
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