Organization
INTENSIVE IN-HOME COUNSELING AND MENTORING DIVISION, LP.
Active
Parent organization
DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC.
Other names
Intensive In-home Counseling Division
Organization subpart
Yes
Provider details
NPI number
Legal business name
DESTINY'S HOUSE RESIDENTIAL SERVICES, LLC.
Authorized official
PATRICE MUHAMMAD (EXECUTIVE DIRECTOR)
(757) 706-3382
Entity
Organization
Contact information
Practice address
6060 JEFFERSON AVE, SUITE 9003, NEWPORT NEWS, VA 23605-3014
(757) 706-3382
(757) 706-3383
Mailing address
6060 JEFFERSON AVE, SUITE 9003, NEWPORT NEWS, VA 23605-3014
(757) 706-3382
(757) 706-3383
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
990
VA
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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