Provider Demographics
NPI:1750754727
Name:DESTINED FOR OPTIONS LLC
Entity type:Organization
Organization Name:DESTINED FOR OPTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-715-1182
Mailing Address - Street 1:3566 N HIGHLAND AVE # B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-7890
Mailing Address - Country:US
Mailing Address - Phone:504-715-1182
Mailing Address - Fax:504-399-1846
Practice Address - Street 1:908 W JUDGE PEREZ DR
Practice Address - Street 2:C
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4773
Practice Address - Country:US
Practice Address - Phone:504-715-1182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child