MEDICARE: DEEP PURPOSE GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1194668442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEP PURPOSE GROUP LLC

Provider Business Mailing Address
First Line	:	7014 OLD TROY PIKE
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2747
Country	:	US
Telephone Number	:	937-231-8117
Fax Number	:

Provider Business Practice Location Address
First Line	:	7014 OLD TROY PIKE
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2747
Country	:	US
Telephone Number	:	937-231-8117
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. DONNIE RAY EVEGE JR.
Credential	:
Telephone Number	:	937-231-8117

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “DEEP PURPOSE GROUP LLC ” Practice Location

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