Organization
DESTINY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JONNA KAY MCCLURE BSW (OWNER)
(719) 564-0163
Entity
Organization
Contact information
Practice address
1339 S PUEBLO BLVD, PUEBLO, CO 81005
(719) 564-0163
(719) 564-0193
Mailing address
1339 S PUEBLO BLVD, PUEBLO, CO 81005
(719) 564-0163
(719) 564-0193
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99500221
—
CO
Enumeration date
03/01/2011
Last updated
12/13/2021
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