MEDICARE: PURPLE GOATS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1447185749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURPLE GOATS LLC

Provider Business Mailing Address
First Line	:	849 RICE ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-5489
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 RICE ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-5489
Country	:	US
Telephone Number	:	651-343-3913
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NASEE LOR
Credential	:
Telephone Number	:	651-343-3913

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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Directions to “PURPLE GOATS LLC ” Practice Location

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