NPI Code Details Logo

NPI 1750084299

NPI 1750084299 : DESTIN COMMUNITY CARE INC : PEARL, MS

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1750084299
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DESTIN COMMUNITY CARE INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/23/2023
-----------------------------------------------------
    Last Update Date     |    08/08/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2731 OLD BRANDON RD 
-----------------------------------------------------
    City                 |    PEARL
-----------------------------------------------------
    State                |    MS
-----------------------------------------------------
    Zip                  |    39208-4702
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    601-249-9868
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 1615 
-----------------------------------------------------
    City                 |    YAZOO CITY
-----------------------------------------------------
    State                |    MS
-----------------------------------------------------
    Zip                  |    39194-1615
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    601-249-9868
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     DE'JA M ALMORE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    601-249-9868
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.