MEDICARE: DESTINY OF HOPE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TC1900X	Counseling Psychologist
2	163W00000X	Registered Nurse
3	174200000X	Meals Provider
4	251J00000X	Nursing Care Agency
5	311Z00000X	Custodial Care Facility
6	311ZA0620X	Adult Care Home Facility
7	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1174145957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESTINY OF HOPE FOUNDATION

Provider Business Mailing Address
First Line	:	1323 W RIVERVIEW AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-6216
Country	:	US
Telephone Number	:	908-590-5283
Fax Number	:

Provider Business Practice Location Address
First Line	:	1323 W RIVERVIEW AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-6216
Country	:	US
Telephone Number	:	908-590-5283
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DESTINYE ELAINE MCLEAN
Credential	:	RN
Telephone Number	:	908-590-5283

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	04/24/2025

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Directions to “DESTINY OF HOPE FOUNDATION ” Practice Location

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