Provider Demographics
NPI:1801363528
Name:YOUR DESTINY HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:YOUR DESTINY HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-277-3187
Mailing Address - Street 1:8033 OLD YORK RD STE 216A
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1422
Mailing Address - Country:US
Mailing Address - Phone:215-277-3187
Mailing Address - Fax:215-690-4089
Practice Address - Street 1:8033 OLD YORK RD STE 216A
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1422
Practice Address - Country:US
Practice Address - Phone:215-277-3187
Practice Address - Fax:215-690-4089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health