Provider Demographics
NPI:1053616276
Name:DESTINY HOMECARE LLC
Entity type:Organization
Organization Name:DESTINY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-944-7100
Mailing Address - Street 1:2775B HARTLAND RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3529
Mailing Address - Country:US
Mailing Address - Phone:703-584-7984
Mailing Address - Fax:703-995-0364
Practice Address - Street 1:2775B HARTLAND RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3529
Practice Address - Country:US
Practice Address - Phone:703-944-7100
Practice Address - Fax:703-995-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-12690251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health