NPIMap

Organization Active NPI

Destiny Awakening Healthcare Services LLC

Doing business as Destiny Caregivers

  • Home Health Agency
  • Newark, NJ
National Provider Identifier
1013503747
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DESTINY AWAKENING HEALTHCARE SERVICES LLC
Doing business as
Destiny Caregivers
Practice address
458 Irvine Turner Blvd
Newark, NJ 07108-2414
Phone
(973) 704-8769
Fax
(862) 305-3790
NPI assigned
Dec 16, 2020
Last updated
Jun 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
-As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Authorized official

Name
Mrs. Linda Emefa Nyomi-Ezeranuna
Title
Manager
Phone
(973) 704-8769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

458 Irvine Turner Blvd
Newark, NJ 07108-2414

Mailing address

458 Irvine Turner Blvd
Newark, NJ 07108-2414
Phone (973) 704-8769

Other identifiers 1

IdentifierTypeStateIssuer
HP0311900MedicaidNJ

Other names 1

  • Destiny Caregivers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Destiny Awakening Healthcare Services LLC2 organizations share this tax ID, including this one
Part of
Destiny Awakening Healthcare Services LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1013503747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 IRVINE TURNER BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071082414",
            "telephone_number": "973-704-8769",
            "fax_number": "862-305-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 IRVINE TURNER BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071082414",
            "telephone_number": "973-704-8769",
            "fax_number": "862-305-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY AWAKENING HEALTHCARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2020-12-16",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "NYOMI-EZERANUNA",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "EMEFA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-704-8769",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HP0311900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Destiny Caregivers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Destiny Caregivers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.