Destiny Home, Inc. #2

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

MHL-032-487 Issued in NC

Legal business name

DESTINY HOME, INC. #2

Practice address

1708 Vintage Rd
Raleigh, NC 27610-3187

Phone

(919) 454-7725

Fax

(919) 231-3736

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Oswald Nwogbo

Title

Ceo

Phone

(919) 454-7725

Specialties & licenses 1

Addresses

Tax ID family

Destiny Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Destiny Home, Inc.

  • Adult Mental Health Clinic/Center
  • Durham, NC
  • NPI 1245371939
  NPD tax ID

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1295965473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 SEVEN OAKS RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277041125",
            "telephone_number": "919-454-7725",
            "fax_number": "919-231-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 VINTAGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103187",
            "telephone_number": "919-454-7725",
            "fax_number": "919-231-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY HOME, INC. #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "NWOGBO",
        "authorized_official_first_name": "OSWALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-454-7725"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "MHL-032-487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Desmond
• Maria Despres, NP
• Kimberly Dessources
• Amy Destefano, MD
• Destiny Family Care Home
• Michael Dettloff
• Donald Gene Detweiler, M.D.
• Lauren Nicole Detweiler, FNP-C
• Leana Oliver Deuel, PT
• Karen Church Devane, LCSW

• Adolescent and Children Mental Health Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Adolescent and Children Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.