Provider Demographics
NPI:1760053284
Name:DESTINY HOSPICE AND PALLIATIVE CARE LLC
Entity Type:Organization
Organization Name:DESTINY HOSPICE AND PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-350-2573
Mailing Address - Street 1:9898 BISSONNET ST STE 670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8059
Mailing Address - Country:US
Mailing Address - Phone:832-350-2573
Mailing Address - Fax:
Practice Address - Street 1:14321 PROSPECT PARK LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-1515
Practice Address - Country:US
Practice Address - Phone:346-254-5488
Practice Address - Fax:936-261-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based