Provider Demographics
NPI:1871510867
Name:DESTINY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:DESTINY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-774-6662
Mailing Address - Street 1:1225 ALABAMA ST
Mailing Address - Street 2:P.O. BOX 59
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1225 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-2805
Practice Address - Country:US
Practice Address - Phone:225-774-6662
Practice Address - Fax:225-774-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA689251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA197650Medicare Oscar/Certification