Organization
DESTINY AWAKENING HEALTHCARE SERVICES LLC
Active
Parent organization
-
Other names
Destiny Caregivers
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
MRS. LINDA EMEFA NYOMI-EZERANUNA (MANAGER)
(973) 704-8769
Entity
Organization
Contact information
Practice address
458 IRVINE TURNER BLVD, NEWARK, NJ 07108-2414
(973) 704-8769
(862) 305-3790
Mailing address
458 IRVINE TURNER BLVD, NEWARK, NJ 07108-2414
(973) 704-8769
(862) 305-3790
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HP0311900
—
NJ
Enumeration date
12/16/2020
Last updated
06/10/2022
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