DESTINY HOMES OF PHYD, INC. (PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT)) NPI 1003005240

Residential Treatment Facility, Emotionally Disturbed Children in Raleigh, NC

Organization Residential Treatment Facility, Emotiona...

About DESTINY HOMES OF PHYD, INC. (PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT))

Destiny Homes Of Phyd, Inc. (phyd, Inc. (pretty Homes Youth Development)) is a provider established in Raleigh, North Carolina specializing in residential treatment facility, emotionally disturbed children. The NPI number of Destiny Homes Of Phyd, Inc. (phyd, Inc. (pretty Homes Youth Development)) is 1003005240 and was assigned on October 2007. The practitioner's primary taxonomy code is 322D00000X with license number MHL-092-537 (NC). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Destiny Homes Of Phyd, Inc.. The authorized official of this NPI record is Mrs. Andrea Pretty (President)

NPI

1003005240

Provider NameDESTINY HOMES OF PHYD, INC. (PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT))
Provider Location Address1611 POOLE RD RALEIGH, NC 27610
Provider Mailing AddressPO BOX 20181 RALEIGH, NC 27619
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameDESTINY HOMES OF PHYD, INC.
Other Name TypeDoing Business As (3)
Enumeration Date10-23-2007
Last Update Date03-26-2009

Primary Taxonomy

Taxonomy Code322D00000X
ClassificationResidential Treatment Facility, Emotionally Disturbed Children
TypeResidential Treatment Facilities
License No.MHL-092-537
License StateNC
Taxonomy DescriptionA provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.

Business Address

DESTINY HOMES OF PHYD, INC.
1611 POOLE RD
RALEIGH, NC
ZIP 27610
Phone: (919) 713-0035
Fax: (919) 713-0034

Get Directions

Mailing Address

DESTINY HOMES OF PHYD, INC.
PO BOX 20181
RALEIGH, NC
ZIP 27619
Phone: (919) 633-7800
Fax: (919) 713-0034

Authorized Official

Authorized Official NameMRS. ANDREA PRETTY
Authorized Official TitlePRESIDENT
Authorized Official Phone(919) 633-7800

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-092-491NCNo

Taxonomy Description: a provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6603862MEDICAID (05)NC
6604280MEDICAID (05)NC

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.