Provider Demographics
NPI:1548718190
Name:DESTINY RECOVERY INC
Entity type:Organization
Organization Name:DESTINY RECOVERY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-971-3333
Mailing Address - Street 1:1800 BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1446
Mailing Address - Country:US
Mailing Address - Phone:818-572-6024
Mailing Address - Fax:909-498-9898
Practice Address - Street 1:1042 E BELMONT ABBEY LN
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1463
Practice Address - Country:US
Practice Address - Phone:909-971-3333
Practice Address - Fax:909-498-9898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-12
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190939AP324500000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA350529OtherCARF
CA190939APOtherDHCS
CA621344OtherJOINT COMMISSION ACCREDITATION