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General NPI Number Information
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NPI Number | 1649995804
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Entity Type | Organization
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Legal Business Name | MY LIFE HAS DESTINY CONSULTING AND BILLING SERVICES LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 04/11/2026
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Provider Practice Location Address
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Address Line | 3131 S CRATER RD STE 3237
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City | PETERSBURG
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State | VA
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Zip | 23805-9218
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Country | US
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Telephone | 678-557-5908
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Fax | 804-203-1657
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Provider Business Mailing Address
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Address Line | PO BOX 3237
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City | PETERSBURG
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State | VA
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Zip | 23805-3237
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Country | US
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Telephone | 678-557-5908
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Fax | 804-203-1657
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AQUINTAS JONES
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Credential | LPN
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Telephone | 678-557-5908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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