NPI 1063734564

Destiny Family Care Home

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Raleigh, NC

Practice location

Address: 5005 Hollyridge Dr, Raleigh, NC 27612-3109
Phone: (919) 789-9811
Fax: (919) 789-9811

Authorised official

Name: Anthonia Uzoamaka Ezuma
Title: Administrator
Phone: (919) 345-4722

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence MHL-092-759 (NC)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Registry record

NPI: 1063734564
Entity type: Organization
NPI issued: 24 Feb 2010
Record last updated: 24 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.