Healthcare Provider Details

I. General information

NPI: 1588377998
Provider Name (Legal Business Name): DESTIN HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2022
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 MEDGAR EVERS BLVD STE 10
JACKSON MS
39213-5205
US

IV. Provider business mailing address

PO BOX 1615
YAZOO CITY MS
39194-1615
US

V. Phone/Fax

Practice location:
  • Phone: 601-249-9868
  • Fax:
Mailing address:
  • Phone: 601-249-9868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DE'JA M ALMORE
Title or Position: OWNER
Credential:
Phone: 601-249-9868