NPIMap

Organization Active NPI

Destination Life LLC

Doing business as SaJourney

  • Occupational Therapist
  • Arlington, TX
National Provider Identifier
1629691167
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
DESTINATION LIFE LLC
Doing business as
SaJourney
Practice address
2001 SE Green Oaks Blvd Ste 130
Arlington, TX 76018-0952
Phone
(817) 473-1312
Fax
(866) 990-2813
NPI assigned
May 19, 2020
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DESTINATION LIFE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Zemelda D. CarrNPI 1790003531
Title
Adm & Auth Rep
Phone
(817) 473-1312

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Nursing Care Agency 251J00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Nurse Practitioner 363L00000X NU
Adult Health Nurse Practitioner 363LA2200X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Primary Care Nurse Practitioner 363LP2300X NU
Women's Health Nurse Practitioner 363LW0102X NU
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X NU
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X NU
Social Worker 104100000X NU
Clinical & Laboratory Immunology (Allergy & Immunology) Physician 207KI0005X NU
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

2001 SE Green Oaks Blvd Ste 130
Arlington, TX 76018-0952

Mailing address

2001 SE Green Oaks Blvd Ste 130
Arlington, TX 76018-0952
Phone (817) 473-1312

Other practice location 1

1759 Broad Park Cir S Ste 113
Mansfield, TX 76063-7836
Phone (817) 473-1312

Other practice location 2

7 Jonathan Way
Ellisville, MS 39437-5195
Phone (817) 473-1312

Other identifiers 3

IdentifierTypeStateIssuer
03320311MedicaidMS
25D2200016OtherMSCLIA
404951201MedicaidTX

Other names 1

  • SaJourney Doing business as

National Provider Directory

National Provider Directory
Part of
Destination Life LLC

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1629691167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SE GREEN OAKS BLVD STE 130",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760180952",
            "telephone_number": "817-473-1312",
            "fax_number": "866-990-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SE GREEN OAKS BLVD STE 130",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760180952",
            "telephone_number": "817-473-1312",
            "fax_number": "866-990-2813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1759 Broad Park Cir S Ste 113",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760637836",
            "country_code": "US",
            "telephone_number": "817-473-1312",
            "fax_number": "866-990-2813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Jonathan Way",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MS",
            "postal_code": "394375195",
            "country_code": "US",
            "telephone_number": "817-473-1312",
            "fax_number": "866-990-2813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DESTINATION LIFE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESTINATION LIFE LLC",
        "enumeration_date": "2020-05-19",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "ZEMELDA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ADM & AUTH REP",
        "authorized_official_telephone_number": "817-473-1312"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03320311",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "25D2200016",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404951201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SaJourney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.