NEW DESTINY PERSONAL HOME (NPI# 1558622423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558622423 |
| Entity Type | Organization |
| Organization Name | NEW DESTINY PERSONAL HOME |
| Other Organization Name | NEW DESTINY PERSONAL CARE HOME ONE INC |
| Practice Address |
308 Longwood Dr Statesboro GA 30461-0828 |
| Practice Telephone | 9122256068 |
| Practice Fax Number | 9122256068 |
| Mailing Telephone | 9122256068 |
| Mailing Fax Number | 9122256068 |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2012-06-06 |
| Authorized Official Name | EMMETT GEORGE SHERRIFF (ADMINISTRATOR) |
| Authorized Official Telephone | 9122256068 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
385HR2055X | GA | Respite Care Facility |
| Other Name | Type Code |
|---|---|
| NEW DESTINY PERSONAL CARE HOME ONE INC | Doing Business As Name - Organization |
| Street Address |
308 LONGWOOD DR |
| City | STATESBORO |
| State | GA |
| Zip Code | 30461-0828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427592765 | Scarlet Gabrielle Shumate | Student in an Organized Health Care Education/Training Program | 1332 Southern Dr., Statesboro, GA 30461 | 2016-12-06 |
| 1164972642 | Olivia Anne Chester | Occupational Therapist | 5968 Lakeview Road, Statesboro, GA 30461 | 2016-10-10 |
| 1760672653 | Dawn Miller | Social Worker | 9017 Oakfield Drive, Statesboro, GA 30461 | 2007-07-27 |
| 1619167608 | Timothy Rollins Ussery | Specialist/Technologist | 16741 Hwy 67 South, Suite 1-a, Statesboro, GA 30461 | 2007-07-26 |
| 1245444579 | Chen-wen Shih | Obstetrics & Gynecology | 4002 Denton Loop, Statesboro, GA 30461 | 2007-05-09 |
| 1215149497 | A. Deo Klein, M.d., P.C. | Specialist | 1161 Sarahlyn Lane, Ste. A, Statesboro, GA 30461 | 2007-05-03 |
| 1568480051 | Robert William Cushner | Podiatrist | 95 Bel Air Drive, Statesboro, GA 30461 | 2006-07-17 |
| 1356619613 | Statesboro Ambulatory Surgery Center, Inc | Clinic/Center | 95 Bel Air Drive, Statesboro, GA 30461 | 2011-12-01 |
| 1497883243 | Jennifer Lea Williamson | Physician Assistant | 1012 Bermuda Run, Statesboro, GA 30461 | 2007-03-02 |
| 1467569376 | Statesboro Ambul Surg Ctr Inc | Clinic/Center | 95 Bel Air Drive, Statesboro, GA 30461 | 2006-08-24 |
| Find all providers in zip 30461 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558784587 | Christine Owen | Respite Care | 1252 Old Gum Log Rd, Blairsville, GA 30512-2065 | 2014-01-27 |
| 1659634020 | Isaiah's House Incorporated | Respite Care | 2301 Burnside Dr, Columbus, GA 31907-3709 | 2012-06-20 |
| 1336458991 | Family Support Circle, Inc. | Respite Care | 1479 Tether Ln, Mcdonough, GA 30253-9209 | 2010-09-30 |
| City | STATESBORO |
| Zip Code | 30461 |
Please comment or provide details below to improve the information on NEW DESTINY PERSONAL HOME.
| 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.