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General NPI Number Information
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NPI Number | 1447143854
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Entity Type | Organization
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Legal Business Name | DESTINY SECURITY GROUP LLC
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 8201 CORPORATE DR STE 630
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City | HYATTSVILLE
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State | MD
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Zip | 20785-2371
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Country | US
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Telephone | 443-853-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 CORPORATE DR STE 630
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City | HYATTSVILLE
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State | MD
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Zip | 20785-2371
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Country | US
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Telephone | 443-853-9292
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OBINNA HERBERTS-NWAEHIHE
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Credential |
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Telephone | 443-853-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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