Provider Demographics
NPI:1992510895
Name:DESTINY QUALITY CARE, LLC
Entity type:Organization
Organization Name:DESTINY QUALITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:MECHELLE
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-464-0828
Mailing Address - Street 1:12939 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-3900
Mailing Address - Country:US
Mailing Address - Phone:813-464-0828
Mailing Address - Fax:888-361-0429
Practice Address - Street 1:780 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8804
Practice Address - Country:US
Practice Address - Phone:813-464-0828
Practice Address - Fax:888-361-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services