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General NPI Number Information
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NPI Number | 1790974517
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Entity Type | Organization
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Legal Business Name | DESTINY HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 327 N QUEEN ST STE. 306
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City | KINSTON
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State | NC
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Zip | 28501-4984
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Country | US
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Telephone | 252-521-1139
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Fax |
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Provider Business Mailing Address
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Address Line | 327 N QUEEN ST STE 306
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City | KINSTON
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State | NC
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Zip | 28501-4987
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Country | US
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Telephone | 252-522-3683
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Fax | 252-522-4355
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Authorized Official
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Title or Position | CEO
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Name | CYNTHIA DIXON TAYLOR
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Credential | RN
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Telephone | 252-522-3683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC3423
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License Number State | NC
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