Provider Demographics
NPI:1467079624
Name:DESTINY HOSPICE CARE
Entity Type:Organization
Organization Name:DESTINY HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:UMOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-356-3920
Mailing Address - Street 1:412 E FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-1300
Mailing Address - Country:US
Mailing Address - Phone:424-331-9191
Mailing Address - Fax:424-309-9399
Practice Address - Street 1:412 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1300
Practice Address - Country:US
Practice Address - Phone:424-331-9191
Practice Address - Fax:424-309-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based