=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558045666
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PURPOSE & PROMISE HOME CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2023
-----------------------------------------------------
Last Update Date | 06/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10483 N FLORIDA AVE UNIT 2
-----------------------------------------------------
City | CITRUS SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34434-3268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-322-8633
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10483 N FLORIDA AVE UNIT 2
-----------------------------------------------------
City | CITRUS SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34434-3268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-322-8633
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CHLOE C EDWARDS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-484-6647
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 372600000X
-----------------------------------------------------
Taxonomy Name | Adult Companion
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------