Provider Demographics
NPI:1629094099
Name:DESTINY HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:DESTINY HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:EFFIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-672-2555
Mailing Address - Street 1:425 E HYDE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-2405
Mailing Address - Country:US
Mailing Address - Phone:310-672-2555
Mailing Address - Fax:310-672-2111
Practice Address - Street 1:425 E HYDE PARK BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-2405
Practice Address - Country:US
Practice Address - Phone:310-672-2555
Practice Address - Fax:310-672-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000339OtherDEPARTMENT OF PUBLIC HEALTH