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General NPI Number Information
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NPI Number | 1295298099
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Entity Type | Organization
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Legal Business Name | PURRE HOME CARE
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 2213 NW 52ND ST
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City | OCALA
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State | FL
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Zip | 34475-3112
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Country | US
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Telephone | 352-484-5487
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 NW 52ND ST
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City | OCALA
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State | FL
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Zip | 34475-3112
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Country | US
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Telephone | 352-484-5487
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS STEPHANIE ALICIA DECOSTER
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Credential | H.H.A/C.N.A
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Telephone | 352-484-5487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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