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Organization Active NPI

Destiny Home Health Services, Inc.

  • Home Health Agency
  • Inglewood, CA
National Provider Identifier
1629094099
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DESTINY HOME HEALTH SERVICES, INC.
Practice address
425 E Hyde Park Blvd
Inglewood, CA 90302-2405
Phone
(310) 672-2555
Fax
(310) 672-2111
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Aniema Effiong
Title
President
Phone
(310) 672-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

425 E Hyde Park Blvd
Inglewood, CA 90302-2405

Mailing address

425 E Hyde Park Blvd
Inglewood, CA 90302-2405
Phone (310) 672-2555

Other identifiers 1

IdentifierTypeStateIssuer
550000339OtherCADEPARTMENT OF PUBLIC HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207001023 CA Part A Provider - Home Health Agency 0446265748 Practice locations: Torrance, CA

Home health agency certification: CCN 059629

Legal name
DESTINY HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 16, 2014
Last certification
Jun 29, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 4, 2003 in CA
Enrollment address
3015 Artesia Blvd
Torrance, CA 90504-2613
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Destiny Home Health Services, IncCCN 059629
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Jun 16, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

425 E Hyde Park Blvd
Inglewood, CA 90302
Phone (310) 672-2555

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John a Ekong Individual 5% Or Greater Direct Ownership Interest May 9, 2006 15%
Corporate DirectorBoard Member Apr 7, 2022 15%
Operational/Managerial ControlDirector of Operations May 9, 2006
Aniema E Umoh Individual 5% Or Greater Direct Ownership Interest Oct 15, 2014 85%
Corporate OfficerCeo/President Oct 1, 2003 85%
Corporate DirectorCeo/President Apr 7, 2022 85%
Robert M Umoh Individual W-2 Managing EmployeeCfo/Administrator Jan 2, 2021 50%
Vivian E Fox Individual Corporate DirectorRegistered Nurse Sep 7, 2021
Inyang E Edem Individual Corporate OfficerSecretary of the Board Sep 20, 2021
Operational/Managerial ControlCommunity Advocate Sep 20, 2021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1629094099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E HYDE PARK BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903022405",
            "telephone_number": "310-672-2555",
            "fax_number": "310-672-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E HYDE PARK BLVD",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903022405",
            "telephone_number": "310-672-2555",
            "fax_number": "310-672-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "EFFIONG",
        "authorized_official_first_name": "ANIEMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-672-2555"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "550000339",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.