Healthcare Provider Details
I. General information
NPI: 1568377950
Provider Name (Legal Business Name): DESTINEE'S CLEANING LLC DBA DESTINEE'S COMPASSIONATE CLEANING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
507 CURTIS ST NE
GRAND RAPIDS MI
49505-5146
US
IV. Provider business mailing address
507 CURTIS ST NE
GRAND RAPIDS MI
49505-5146
US
V. Phone/Fax
- Phone: 616-635-7422
- Fax:
- Phone: 616-635-7422
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DESTINEE
JACKSON
Title or Position: CEO
Credential:
Phone: 616-635-7422