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General NPI Number Information
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NPI Number | 1164174256
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Entity Type | Organization
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Legal Business Name | DESTINY LIFE PARTNERS, LLC
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 185 STIMSON RD
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City | NEW HAVEN
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State | CT
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Zip | 06511-1670
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Country | US
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Telephone | 203-623-5968
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Fax |
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Provider Business Mailing Address
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Address Line | 1449 WHALLEY AVE UNIT 3840
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City | NEW HAVEN
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State | CT
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Zip | 06525-7718
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Country | US
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Telephone | 203-623-5968
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. SIBYL DAWN BROOKS
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Credential |
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Telephone | 203-623-5968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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