DESTINY LIFE CENTER COG (NPI# 1679044960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679044960 |
Entity Type | Organization |
Organization Name | DESTINY LIFE CENTER COG |
Practice Address |
518 E Jefferson Blvd Fort Wayne IN 46802-3204 |
Practice Telephone | 2605576183 |
Mailing Telephone | 2605576183 |
Enumeration Date | 2018-12-11 |
Last Update Date | 2018-12-11 |
Authorized Official Name | PATRICIA JIMERSON (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 2605576183 |
Is Organization Subpart | Y |
Parent Organization Name | GENERAL ASSEMBLY OF THE CHURCH OF GOD |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 174200000X | Meals | Other Service Providers | ||
N | 177F00000X | Lodging | Other Service Providers | ||
N | 251S00000X | Community/Behavioral Health | Agencies | ||
Y | 253Z00000X | In Home Supportive Care | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | RECOVERY WORKS HOUSING | 35257218 | 01 |
IN | 05 | 05 |
Other Name | Type Code |
---|---|
Victory House for women | Doing Business As Name - Organization |
Victory House for women | Other Name - Individual/Organization |
Street Address |
518 E JEFFERSON BLVD |
City | FORT WAYNE |
State | IN |
Zip Code | 46802-3204 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
1699260182 | Tina Huffman Counseling Services LLC | Clinic/Center | 2323 111 W. Berry St., Fort Wayne, IN 46802 | 2018-06-27 |
1669879664 | Neighborhood Health Clinics, Inc | Clinic/Center | 1721 S Calhoun St, Fort Wayne, IN 46802 | 2014-11-20 |
1205272168 | Tyler Jerome Kimmel | Dentist | 1717 S. Calhoun Street, Fort Wayne, IN 46802 | 2013-05-20 |
1174899405 | Hearcare Connection, Inc. | Audiologist | 130 W Main St Ste 150, Fort Wayne, IN 46802 | 2012-03-30 |
1801114533 | Hoosier Sports & Chiropractic LLC | Chiropractor | 122 W Wayne Street, Fort Wayne, IN 46802 | 2010-05-05 |
1891912523 | Krista Lohmar | Speech-Language Pathologist | 3340 North Washington Road, Ft. Wayne, IL 46802 | 2007-04-20 |
1811047608 | Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. | Counselor | 915 South Clinton, Fort Wayne, IN 46802 | 2007-01-12 |
1548323801 | Clifford T Salk | Dentist | 122 W Washington Blvd, Fort Wayne, IN 46802 | 2006-12-18 |
1720155492 | Kristina Wise | Social Worker | 203 W Wayne St Ste 317, Fort Wayne, IN 46802 | 2006-11-29 |
Find all providers in zip 46802 |
Taxonomy Code | 253Z00000X |
Grouping | Agencies |
Classification | In Home Supportive Care |
An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548887250 | Sykes Home Care, LLC | In Home Supportive Care | 5534 Saint Joe Rd, Fort Wayne, IN 46835-3328 | 2020-06-29 |
1679124028 | Compassionate Care Services | In Home Supportive Care | 5812 W Hills Rd, Fort Wayne, IN 46804-6358 | 2019-09-26 |
1316596786 | Infinity Home Care Agency Inc. | In Home Supportive Care | 7508 S Anthony Blvd, Fort Wayne, IN 46816-2523 | 2019-09-09 |
1992359632 | Hih Fort Wayne, LLC D/b/a | In Home Supportive Care | 820 Mill Lake Rd, Fort Wayne, IN 46845-6400 | 2019-07-31 |
1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
1518402288 | Leap of Faith Enterprises, Inc. | In Home Supportive Care | 4110 Lower Huntington Rd, Fort Wayne, IN 46809-7900 | 2017-01-04 |
1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
1194171827 | Generation Home Care LLC | In Home Supportive Care | 5800 Fairfield Ave Ste 205, Fort Wayne, IN 46807-3400 | 2016-05-12 |
1356716237 | Foote Family Home Care, LLC | In Home Supportive Care | 7211 Miahqueah Ct, Fort Wayne, IN 46815-7943 | 2015-12-03 |
1508264870 | Attentive Resources, LLC | In Home Supportive Care | 3354 Garland Ave, Fort Wayne, IN 46805-1724 | 2014-12-18 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46802 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.