DESTINY LIFE CENTER COG


Address: 518 E Jefferson Blvd, Fort Wayne, IN 46802-3204
Phone: 2605576183

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
IN RECOVERY WORKS HOUSING 35257218 01
IN 05 05

Other Provider/Organization Names

Other Name Type Code
Victory House for women Doing Business As Name - Organization
Victory House for women Other Name - Individual/Organization

Office Location

Street Address 518 E JEFFERSON BLVD
City FORT WAYNE
State IN
Zip Code 46802-3204

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 253Z00000X
Grouping Agencies
Classification In Home Supportive Care

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City FORT WAYNE
Zip Code 46802

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Dataset Information

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.

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