Provider Demographics
NPI:1609038231
Name:DESTINY HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:DESTINY HOME HEALTH AGENCY, INC
Other - Org Name:DESTINY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DON / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ILOCHI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN/RN
Authorized Official - Phone:713-782-7400
Mailing Address - Street 1:3300 S GESSNER RD STE 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5139
Mailing Address - Country:US
Mailing Address - Phone:713-782-7400
Mailing Address - Fax:713-782-7402
Practice Address - Street 1:3300 S GESSNER RD STE 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5139
Practice Address - Country:US
Practice Address - Phone:713-782-7400
Practice Address - Fax:713-782-7402
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTINY HOME HEALTH AGENCY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-25
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health