Individual ProviderDestini CarrBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address17390 Dugdale Dr Suite 100, South Bend, IN 46635(574) 400-2169(855) 324-0885PECOS EnrollmentBased on the most recent information from CMS, provider Destini Carr does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:33 PM.Profile DetailsProvider ID1073104246Provider TypeIndividualFull NameCarr, DestiniCredentialRBTGenderFemaleSole ProprietorNoEnumeration Date2/1/2021Last Updated2/1/2021Contact InformationPractice LocationPractice Address17390 Dugdale Dr Suite 100, South Bend, IN 46635Phone(574) 400-2169Fax(317) 520-8200Mailing LocationMailing Address3500 Depauw Blvd Suite 3070, Indianapolis, IN 46268Phone(855) 324-0885Fax(317) 520-8200Provider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-21-153482Indiana