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Divon Group Home For Young Adults

Case Management in Alexandria, VA. Organization (NPI-2).

NPI number1376398479
StatusActive
Last updated in NPPESNov 18, 2025

Details

NPI
1376398479
Entity type
Organization (NPI-2)
Legal business name
Divon Group Home For Young Adults
Organization subpart
No
Enumeration date
Apr 22, 2024
Certification date
Nov 18, 2025
Last updated
Nov 18, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251B00000X Case Management––Yes
253Z00000X In Home Supportive Care––
171M00000X Case Manager/Care Coordinator––

Other names

  • Divine Destiny (Doing Business As)

Practice location

4324 Vermont Ave
Alexandria, VA 22304-4922

Phone 703-965-0739

Mailing address

4324 Vermont Ave
Alexandria, VA 22304-4922

Phone 703-965-0739

Authorized official

Takahya Everett-Gatlin
Owner
7039650739

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