Destiny Adult Home Day Care

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

2012013672 Issued in GA

Legal business name

DESTINY ADULT HOME DAY CARE

Practice address

3363 Pinegate TRL
Snellville, GA 30039-8815

Phone

(770) 648-6960

NPI assigned

Aug 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Velena Mixon

Title

Owner/Director

Phone

(404) 434-6711

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1083963607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3363 PINEGATE TRL",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 PINEGATE TRL",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398815",
            "telephone_number": "770-648-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY ADULT HOME DAY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "MIXON",
        "authorized_official_first_name": "VELENA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "404-434-6711"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "2012013672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Safari LTD
• Toniann Deoliviera, RPT
• Michael A Derosa, MD
• Roopa M Desai, PT
• Myrlene Desrosiers, FNP
• Gabrielle Deverteuil
• Gamel Dewese, THERAPIST
• Tanvi Mamud Dhanani, PA-C
• Diabetes and Endocrinology of Snellville, LLC
• Matthew Dial, RBT

• Adult Care Home Facility in Snellville, GA
• Providers in Snellville, GA by specialty
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.