Newly Destined, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NEWLY DESTINED, INC.

Practice address

920 Broad St # 1114
Newark, NJ 07102-2660

Phone

(973) 242-8088

Fax

(973) 242-8069

NPI assigned

Apr 10, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Ruben Johnson Sr.

Title

Ceo

Phone

(973) 477-7639

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1477796191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 BROAD STREET",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-242-8088",
            "fax_number": "973-242-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 BROAD ST # 1114",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022660",
            "telephone_number": "973-242-8088",
            "fax_number": "973-242-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWLY DESTINED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-10",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-477-7639",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Newark Renaissance House, Inc
• Newark Renaissance House, Inc
• Newark Renaissance House, Inc
• Newark Renal Centers, LLC
• Newark Vein and Vascular Center LLC
• Brian Keith Newsome
• Nextpath Support Services LLC
• Praise Nformi, MD
• Enoch NG
• Suilon NG

• Substance Abuse Rehabilitation Facility in Newark, NJ
• Providers in Newark, NJ by specialty
• Substance Abuse Rehabilitation Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.