Healthcare Provider Details

I. General information

NPI: 1194282020
Provider Name (Legal Business Name): DESTINED HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 FORBES BLVD STE 200
LANHAM MD
20706-6316
US

IV. Provider business mailing address

4500 FORBES BLVD STE 200
LANHAM MD
20706-6316
US

V. Phone/Fax

Practice location:
  • Phone: 301-979-0632
  • Fax:
Mailing address:
  • Phone: 301-979-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIAMA SESAY
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 301-979-0632