Active NPI
Destiny Awakening Healthcare Services LLC
- Home Health Registered Nurse
- Newark, NJ
National Provider Identifier
1215630231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- Legal business name
- DESTINY AWAKENING HEALTHCARE SERVICES LLC
- Practice address
- 458 Irvine Turner Blvd
Newark, NJ 07108-2414 - Phone
- (973) 704-8769
- Fax
- (862) 305-3790
- NPI assigned
- Mar 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda Emefa Nyomi-Ezeanuna
- Title
- Manager
- Phone
- (862) 571-7577
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | Primary |
Addresses
Primary practice location
458 Irvine Turner Blvd
Newark, NJ 07108-2414
Mailing address
458 Irvine Turner Blvd
Newark, NJ 07108-2414
Phone (862) 571-7577
Other names 1
- Destiny Caregivers
National Provider Directory
National Provider Directory- Tax ID family
- 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.
-
- Home Health Agency
- Newark, NJ
- NPI 1013503747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679875200000",
"number": "1215630231",
"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": "862-571-7577"
},
{
"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": "NO",
"enumeration_date": "2023-03-27",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A",
"authorized_official_last_name": "NYOMI-EZEANUNA",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "EMEFA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "862-571-7577"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"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 Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.