Provider Demographics
NPI:1508511221
Name:DESTINYS LOVING HOME LLC
Entity Type:Organization
Organization Name:DESTINYS LOVING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESTINY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:AL
Authorized Official - Phone:480-859-0481
Mailing Address - Street 1:11282 E POINSETTIA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-3144
Mailing Address - Country:US
Mailing Address - Phone:480-859-0481
Mailing Address - Fax:480-371-3477
Practice Address - Street 1:11282 E POINSETTIA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-3144
Practice Address - Country:US
Practice Address - Phone:480-859-0481
Practice Address - Fax:480-371-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility