Provider Demographics
NPI:1215211420
Name:THE CENTER OF DESTINY, INC.
Entity Type:Organization
Organization Name:THE CENTER OF DESTINY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:WIGGINS
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-496-1146
Mailing Address - Street 1:7027 MILLERS GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4184
Mailing Address - Country:US
Mailing Address - Phone:901-496-1146
Mailing Address - Fax:888-355-7312
Practice Address - Street 1:7027 MILLERS GLEN WAY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-4184
Practice Address - Country:US
Practice Address - Phone:901-496-1146
Practice Address - Fax:888-355-7312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable