Provider Demographics
NPI:1720598469
Name:ADESTINY'S HORIZON
Entity Type:Organization
Organization Name:ADESTINY'S HORIZON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:IDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-380-4994
Mailing Address - Street 1:199 RAILROAD AVE STE 3B
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1915
Mailing Address - Country:US
Mailing Address - Phone:973-380-4994
Mailing Address - Fax:973-679-2784
Practice Address - Street 1:199 RAILROAD AVE STE 3B
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1915
Practice Address - Country:US
Practice Address - Phone:973-380-4994
Practice Address - Fax:973-679-2784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0639532Medicaid