Healthcare Provider Details

I. General information

NPI: 1922782671
Provider Name (Legal Business Name): PASSION 4 PURPOSE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 VILLAGE TRCE NE BLDG 23 UNIT 306
MARIETTA GA
30067-4069
US

IV. Provider business mailing address

600 VILLAGE TRCE NE BLDG 23 UNIT 306
MARIETTA GA
30067-4069
US

V. Phone/Fax

Practice location:
  • Phone: 678-689-5587
  • Fax:
Mailing address:
  • Phone: 678-689-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY PORTER
Title or Position: OWNER
Credential:
Phone: 757-201-2344