MEDICARE: DESTINATION LIFE LLC-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	261QD1600X	Developmental Disabilities Clinic/Center
4	261QH0700X	Hearing and Speech Clinic/Center
5	261QM1300X	Multi-Specialty Clinic/Center
6	261QR0400X	Rehabilitation Clinic/Center
7	291U00000X	Clinical Medical Laboratory
8	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
9	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45D2207166	OTHER	TX	CLIA
2	482228	OTHER	TX	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	25D2200016	OTHER	MS	CLIA MS
5	567960000	OTHER	TX	THERAPY CLINIC

General Provider Information

NPI Number	:	1831712413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESTINATION LIFE LLC-S

Provider Business Mailing Address
First Line	:	2001 SE GREEN OAKS BLVD STE 130
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-0952
Country	:	US
Telephone Number	:	817-473-1312
Fax Number	:	866-990-2813

Provider Business Practice Location Address
First Line	:	2001 SE GREEN OAKS BLVD STE 130
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-0952
Country	:	US
Telephone Number	:	817-473-1312
Fax Number	:	866-990-2813

Authorized Official
Title or Position	:	ADM & AUTH REP
Name	:	ZEMELDA D. CARR
Credential	:
Telephone Number	:	817-473-1312

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	07/30/2021

Similar Medicare Providers

1801078753 — MARK DIRNBERGER DO PA
Practice Location Address:

2001 SE GREEN OAKS BLVD. , SUITE # 130
ARLINGTON, TX
76018-0952

Practice Phone: 817-419-6111
Practice Fax: 817-572-7982

1790003531 — ZEMELDA D. CARR OTR/L, MOT, CST
Practice Location Address:

2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
76018-0952

Practice Phone: 817-473-1312
Practice Fax: 866-990-2813

1114328416 — DESTINATION LIFE LLC
Practice Location Address:

2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
76018-0952

Practice Phone: 817-473-1312
Practice Fax: 866-990-2813

1588287163 — DESTINATION LIFE LLC
Practice Location Address:

2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
76018-0952

Practice Phone: 817-473-1312
Practice Fax: 866-990-2813

1629691167 — DESTINATION LIFE LLC
Practice Location Address:

2001 SE GREEN OAKS BLVD STE 130
ARLINGTON, TX
76018-0952

Practice Phone: 817-473-1312
Practice Fax: 866-990-2813

1275390825 — NTB HEALTH SERVICES
Practice Location Address:

624 ENGLESIDE DR
ARLINGTON, TX
76018-5106

Practice Phone: 989-737-9202
Practice Fax:

Directions to “DESTINATION LIFE LLC-S ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.