Destiny's Fulfilled L.l.c.

NPI #1891764882 in Richmond, Virginia

Provider Information

NPI Number: 1891764882
Entity Type: Organization
Organization Name: Destiny's Fulfilled L.l.c.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 14, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1908 CHEVELLE DR
City: Richmond
State: Virginia
ZIP Code: 23235-5641
Phone: (804) 276-1702

Authorized Official

Name: MISS STACEY MICHELLE COOK
Title: CHIEF EXECTUIVE OFFICER
Phone: (804) 276-1702

Specialties & Taxonomy Codes

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

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