MEDICARE: DESTINY FAMILY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1740027259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESTINY FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	1251 KEMPER MEADOW DR STE 100B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1767
Country	:	US
Telephone Number	:	513-595-1559
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 KEMPER MEADOW DR STE 100B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1767
Country	:	US
Telephone Number	:	513-595-1559
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNTING CLERK
Name	:	LISA WILLIAMS
Credential	:
Telephone Number	:	513-595-1559

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	07/11/2024

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