Organization
DESTINYS SUPPORTIVE IN-HOME SERVICES
Active
Parent organization
DESTINYS HOUSE RESIDENTIAL SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DESTINYS HOUSE RESIDENTIAL SERVICES
Authorized official
PATRICE MATTHEWS (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
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
990
VA
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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