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Organization
DESTINY EMPOWERMENT HOUSE AND GROUPS LLC
Active
Organization
DESTINY EMPOWERMENT HOUSE AND GROUPS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALDINE ANAMEGE (ADMINISTRATOR)
(570) 269-2423
Entity
Organization
Contact information
Practice address
5013 PINE RIDGE RD S, EAST STROUDSBURG, PA 18302-8669
(570) 269-2423
Mailing address
5013 PINE RIDGE RD S, EAST STROUDSBURG, PA 18302-8669
(570) 269-2423
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN572318
PA
251F00000X
Home Infusion Agency
RN572318
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN572318
BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
12/20/2016
Last updated
04/17/2017
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