MEDICARE: IN DESTINY'S HANDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1487349148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN DESTINY'S HANDS LLC

Provider Business Mailing Address
First Line	:	1715 IVEY POINTE CT
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-2650
Country	:	US
Telephone Number	:	470-242-9099
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 IVEY POINTE CT
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-2650
Country	:	US
Telephone Number	:	470-242-9099
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DESTINY HARRIS
Credential	:
Telephone Number	:	470-242-9099

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	05/04/2026

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