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General NPI Number Information
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NPI Number | 1538625975
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Entity Type | Organization
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Legal Business Name | PURPOSEFUL RESIDENTIAL CARE, LLC
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 01/27/2024
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Provider Practice Location Address
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Address Line | 1308 ERIE ST
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City | BAKERSFIELD
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State | CA
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Zip | 93307-3974
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Country | US
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Telephone | 661-412-4541
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Fax |
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Provider Business Mailing Address
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Address Line | 5701 TRUXTUN AVE STE 220
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0402
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Country | US
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Telephone | 661-378-3764
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Fax | 661-344-4266
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Authorized Official
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Title or Position | ADMINISTRATOR/EXECUTIVE ASSISTANT
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Name | ADONICA NELL VICKERS
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Credential |
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Telephone | 661-378-3764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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