DESTINATION LIFE LLC-S NPI 1831712413

NPI Information

NPI: 1831712413
Provider Name: DESTINATION LIFE LLC-S

Doing Business As: DESTINATION THERAPY

Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
ZIP 76018
Phone: (817) 473-1312
Get Directions

DESTINATION LIFE LLC-S is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Arlington, TX. DESTINATION LIFE LLC-S NPI is 1831712413. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Destination Therapy.

The provider's business location address is:

2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
ZIP 76018-952
Phone: (817) 473-1312
Fax: (866) 990-2813

The provider's authorized official is Zemelda D. Carr .
The authorized official title is Adm & Auth Rep and has the following contact phone number (817) 473-1312.

The enumeration date for this NPI number is 5/18/2020 and was last updated on 7/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	225100000X	Physical Therapist		No
2	225X00000X	Occupational Therapist		No
3	261QD1600X	Clinic/Center	Developmental Disabilities	No
4	261QH0700X	Clinic/Center	Hearing and Speech	No
5	261QM1300X	Clinic/Center	Multi-Specialty	No
6	261QR0400X	Clinic/Center	Rehabilitation	No
7	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	Yes
8	291U00000X	Clinical Medical Laboratory		No
9	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	45D2207166	OTHER	TEXAS	CLIA
2	404951201	MEDICAID	TEXAS
3	482228	OTHER	TEXAS	PTAN
4	25D2200016	OTHER	MISSISSIPPI	CLIA MS
5	567960000	OTHER	TEXAS	THERAPY CLINIC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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