Healthcare Provider Details

I. General information

NPI: 1548718190
Provider Name (Legal Business Name): DESTINY RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 E BELMONT ABBEY LN
CLAREMONT CA
91711-1463
US

IV. Provider business mailing address

1800 BEL AIRE DR
GLENDALE CA
91201-1446
US

V. Phone/Fax

Practice location:
  • Phone: 909-971-3333
  • Fax: 909-498-9898
Mailing address:
  • Phone: 909-971-3333
  • Fax: 909-498-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number190939AP
License Number StateCA

VIII. Authorized Official

Name: DIANA ROZENOYER
Title or Position: PRESIDENT
Credential:
Phone: 818-572-6024