Healthcare Provider Details

I. General information

NPI: 1639847841
Provider Name (Legal Business Name): PURPLE KEYS HOME CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9219 SHERATON PARK WAY
MONTGOMERY AL
36117-9312
US

IV. Provider business mailing address

9219 SHERATON PARK WAY
MONTGOMERY AL
36117-9312
US

V. Phone/Fax

Practice location:
  • Phone: 334-245-1163
  • Fax:
Mailing address:
  • Phone: 334-652-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTIAN WILLIAMS
Title or Position: OWNER
Credential: CRNP
Phone: 334-652-9300