Organization
DESTINY HOME HEALTH AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY NSEMEKE EKPO (ADMINISTRATOR)
(951) 242-1365
Entity
Organization
Contact information
Practice address
12981 PERRIS BLVD,, SUITE 214, MORENO VALLEY, CA 92553-4112
(951) 242-1365
(951) 242-1387
Mailing address
PO BOX 1000, MORENO VALLEY, CA 92556-1000
(951) 242-1365
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
250000800
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750484085
—
CA
05
—
HHA08263F
—
CA
Enumeration date
09/05/2006
Last updated
04/03/2019
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