Provider Demographics
NPI:1841284981
Name:DESTINYS HOME HEALTH CARE
Entity type:Organization
Organization Name:DESTINYS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:UGWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-321-1323
Mailing Address - Street 1:2331 GUS THOMASSON RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3039
Mailing Address - Country:US
Mailing Address - Phone:214-321-1323
Mailing Address - Fax:
Practice Address - Street 1:2331 GUS THOMASSON RD
Practice Address - Street 2:SUITE 137
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3039
Practice Address - Country:US
Practice Address - Phone:214-321-1323
Practice Address - Fax:214-321-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-05
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008153251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679244Medicare ID - Type Unspecified