Destination Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DESTINATION ASSISTED LIVING HOME LLC

Practice address

11238 E Utah Ave
Mesa, AZ 85212-6534

Phone

(480) 593-4708

NPI assigned

Jan 27, 2025

Organization subpart

No

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

Authorized official

Name

Caroline Wanjiku Njoroge

Title

Manager

Phone

(480) 593-4708

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1376356253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11238 E UTAH AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852126534",
            "telephone_number": "480-593-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11238 E UTAH AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852126534",
            "telephone_number": "480-593-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINATION ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "NJOROGE",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "WANJIKU",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-593-4708"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Christine Desouza, RN
• Samuel Kobina Desouza Jr., PA-C
• Samantha Desruisseaux, APRN-RNP
• Dessalines Sports Medicine, LLC
• Amanda M Destefano-Marks
• Rachel Renee Desvergnes
• Jessica Dettra, P.A.
• Florence Wairimu Deuel, PMHNP-BC
• Collin Deutscher, DC
• Hemikaa Devakumar

• Assisted Living Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.