Destiny Rose Residential Care Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

00000000000000000000 Issued in TX

Legal business name

DESTINY ROSE RESIDENTIAL CARE FACILITY

Practice address

1620 Glen Ave
Dallas, TX 75216-1727

Phone

(214) 335-0627

Fax

(214) 941-0308

NPI assigned

Nov 1, 2011

Organization subpart

No

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

Authorized official

Name

Toni Martin-Moore

Title

Owner

Phone

(214) 778-7228

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1386920536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 543174",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750543174",
            "telephone_number": "214-778-7228",
            "fax_number": "214-377-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 GLEN AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752161727",
            "telephone_number": "214-335-0627",
            "fax_number": "214-941-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY ROSE RESIDENTIAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN-MOORE",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-778-7228"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "00000000000000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Despaint, CRT
• Walton Matthew Desplas, RN
• Jaylin Izabella Destefano-Malik
• Nancy Morrison Destefano, LCSW
• Destiny Rose Healthcare Services Inc
• Destinys Home Health Care
• Brent Steven Desutter, D.D.S.
• Mirinda Marie Detloff
• Halle Grace Detrixhe
• Nathan Dettori, M.D.

• Assisted Living Facility in Dallas, TX
• Providers in Dallas, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.