OrganizationActive
Destiny'S Fulfilled Inc
NPI 1831254119 · Emotionally Disturbed Childrens' Residential Treatment Facility · Richmond, VA
Provider details
- NPI number
- 1831254119
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Stacey Cook, Chief Executive Offier(804) 276-1702
- License
- SS06320 (VA)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense SS06320 (VA)
Residential Treatment Facilities
Practice location
1908 Chevelle Dr
Richmond, VA 23235-5641
Phone: (804) 276-1702
Fax: (804) 276-6051
Approximate (ZIP-level) locationGet directions
Mailing address
1908 Chevelle Dr
Richmond, VA 23235-5641
Registry dates
- Enumerated
- 2006-12-27
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.