Healthcare Provider Details

I. General information

NPI: 1407040801
Provider Name (Legal Business Name): THE NEW DESTINY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W WASHINGTON BLVD SUITE 517
LOS ANGELES CA
90015-3552
US

IV. Provider business mailing address

155 WEST WASHINGTON BLVD SUITE 517
LOS ANGELES CA
90015
US

V. Phone/Fax

Practice location:
  • Phone: 323-304-0054
  • Fax: 323-935-0663
Mailing address:
  • Phone: 323-304-0054
  • Fax: 323-935-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number7131
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number7131
License Number StateCA

VIII. Authorized Official

Name: MR. NII AHUMA OCANSEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 323-304-0054