DESTINY RESIDENTIAL LLC – NPI #1578412409
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

DESTINY RESIDENTIAL LLC is a community based residential treatment facility located in DANVILLE, IN. NPPES has assigned the NPI number 1578412409 to DESTINY RESIDENTIAL LLC on January 23, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DESTINY RESIDENTIAL LLC below.

NPI Profile for
DESTINY RESIDENTIAL LLC

NPI Number
1578412409
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DESTINY RESIDENTIAL LLC
Primary location
4030 CANNING ST
DANVILLE, IN 46122-6009
Phone: (904) 731-6454 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JUSTIN NDIZEYE
CFO
Phone: (904) 731-6454
Updated
Certification Date
Jan 23, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.