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General NPI Number Information
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NPI Number | 1972134104
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Entity Type | Organization
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Legal Business Name | DESTINY SERVICES INC
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 270 LAWRENCE ST APT 18
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City | LOWELL
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State | MA
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Zip | 01852-3593
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Country | US
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Telephone | 978-726-5310
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Fax |
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Provider Business Mailing Address
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Address Line | 270 LAWRENCE ST APT 18
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City | LOWELL
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State | MA
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Zip | 01852-3593
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Country | US
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Telephone | 978-726-5310
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | HENRY MASEMBE
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Credential |
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Telephone | 781-492-0959
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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