Provider Demographics
NPI:1528838786
Name:DESTINY HEALTHCARE CORPORATION
Entity type:Organization
Organization Name:DESTINY HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-870-6477
Mailing Address - Street 1:417 W BROAD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3326
Mailing Address - Country:US
Mailing Address - Phone:240-870-6477
Mailing Address - Fax:240-208-1269
Practice Address - Street 1:417 W BROAD ST STE 202
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3326
Practice Address - Country:US
Practice Address - Phone:240-870-6477
Practice Address - Fax:240-208-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health