Provider Demographics
NPI:1235908658
Name:DESTINYE STAFFING SERVICES LLC
Entity type:Organization
Organization Name:DESTINYE STAFFING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-590-5283
Mailing Address - Street 1:119 AUGUSTA PLANTATION DR UNIT F
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-6440
Mailing Address - Country:US
Mailing Address - Phone:909-590-5283
Mailing Address - Fax:
Practice Address - Street 1:119 AUGUSTA PLANTATION DR UNIT F
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6440
Practice Address - Country:US
Practice Address - Phone:909-590-5283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTINYE STAFFING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy