Destiny Residential LLC

NPI #1578412409 in Danville, Indiana

Provider Information

NPI Number: 1578412409
Entity Type: Organization
Organization Name: Destiny Residential LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 23, 2026
Last Updated: Jan 23, 2026

Practice Location

Address: 4030 CANNING ST
City: Danville
State: Indiana
ZIP Code: 46122-6009
Phone: (904) 731-6454

Authorized Official

Name: MR. JUSTIN NDIZEYE
Title: CFO
Phone: (904) 731-6454

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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