Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Destiny Residential LLC

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1578412409

Destiny Residential LLC is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Danville, Indiana. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4030 Canning St
Danville, IN 46122-6009
Phone: (904) 731-6454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X

Record details

NPI number1578412409
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justin Ndizeye — Cfo · (904) 731-6454
NPI enumeratedJanuary 23, 2026
Last updated in NPPESJanuary 23, 2026
Certification dateJanuary 23, 2026
Mailing address4030 Canning St, Danville, IN 46122-6009

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