Provider Demographics
NPI:1043776909
Name:DESTINYE STAFFING SERVICES
Entity Type:Organization
Organization Name:DESTINYE STAFFING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-590-5283
Mailing Address - Street 1:1323 W RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-6216
Mailing Address - Country:US
Mailing Address - Phone:908-590-5283
Mailing Address - Fax:
Practice Address - Street 1:119 AUGUSTA PLANTATION DR UNIT F
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6440
Practice Address - Country:US
Practice Address - Phone:908-590-5283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTINYE STAFFING SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-15
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No177F00000XOther Service ProvidersLodging
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization