Healthcare Provider Details

I. General information

NPI: 1306197074
Provider Name (Legal Business Name): DESTINY CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7083 WEURFUL DR
CANAL WINCHESTER OH
43110-8436
US

IV. Provider business mailing address

7083 WEURFUL DR
CANAL WINCHESTER OH
43110-8436
US

V. Phone/Fax

Practice location:
  • Phone: 614-271-2490
  • Fax: 614-321-6080
Mailing address:
  • Phone: 614-271-2490
  • Fax: 614-321-6080

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: MR. BLAISE RAYMOND MVOA OLAMA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.B.A
Phone: 614-271-2490