Organization
DIVON DESTINY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAKAHYA EVERETT-GATLIN (OWNER)
(703) 965-0739
Entity
Organization
Contact information
Practice address
4324 VERMONT AVE, ALEXANDRIA, VA 22304-4922
(703) 965-0739
Mailing address
4324 VERMONT AVE, ALEXANDRIA, VA 22304-4922
(703) 965-0739
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/02/2025
Last updated
11/24/2025
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