Provider Demographics
NPI:1073106837
Name:DESTI HOMECARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:DESTI HOMECARE SOLUTIONS LLC
Other - Org Name:DESTI HOMECARE SOLUTIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-731-3255
Mailing Address - Street 1:176 AMITY RD STE 218
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2239
Mailing Address - Country:US
Mailing Address - Phone:475-731-3255
Mailing Address - Fax:
Practice Address - Street 1:1695 QUINNIPIAC AVE
Practice Address - Street 2:SUITE D
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513
Practice Address - Country:US
Practice Address - Phone:475-731-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health