NPIMap

Organization Active NPI

Destiny Residential Care, LLC

  • Community/Behavioral Health Agency
  • Westbrook, ME
National Provider Identifier
1104596493
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DESTINY RESIDENTIAL CARE, LLC
Practice address
15 Teri Cir Apt 82
Westbrook, ME 04092-3972
Phone
(207) 317-7828
NPI assigned
Sep 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Anicet Bakunda
Title
Managing Member
Phone
(207) 317-7828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

15 Teri Cir Apt 82
Westbrook, ME 04092-3972

Mailing address

15 Teri Cir Apt 82
Westbrook, ME 04092-3972
Phone (207) 317-7828

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1104596493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TERI CIR APT 82",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923972",
            "telephone_number": "207-317-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TERI CIR APT 82",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923972",
            "telephone_number": "207-317-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "BAKUNDA",
        "authorized_official_first_name": "ANICET",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "207-317-7828"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.