Healthcare Provider Details
I. General information
NPI: 1235070434
Provider Name (Legal Business Name): DESTIN COMMUNITY CARE,INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2731 OLD BRANDON RD
PEARL MS
39208-4702
US
IV. Provider business mailing address
2731 OLD BRANDON RD
PEARL MS
39208-4702
US
V. Phone/Fax
- Phone: 601-249-9868
- Fax:
- Phone: 601-249-9868
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEJA
M
ALMORE
Title or Position: OWNER
Credential:
Phone: 601-249-9868