Provider Demographics
NPI:1275677551
Name:DESTINY MANAGEMENT INCORPORATED
Entity Type:Organization
Organization Name:DESTINY MANAGEMENT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:828-430-0438
Mailing Address - Street 1:PO BOX 537
Mailing Address - Street 2:
Mailing Address - City:DREXEL
Mailing Address - State:NC
Mailing Address - Zip Code:28619-0537
Mailing Address - Country:US
Mailing Address - Phone:828-391-8282
Mailing Address - Fax:828-391-8288
Practice Address - Street 1:209 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:DREXEL
Practice Address - State:NC
Practice Address - Zip Code:28619-0000
Practice Address - Country:US
Practice Address - Phone:828-391-8282
Practice Address - Fax:828-391-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3418007251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418007Medicaid