MEDICARE: PURPOSE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811187438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURPOSE, INC

Provider Business Mailing Address
First Line	:	PO BOX 573
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-1049
Country	:	US
Telephone Number	:
Fax Number	:	770-948-9090

Provider Business Practice Location Address
First Line	:	5655 AUSTELL POWDER SPRINGS RD
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30106-3315
Country	:	US
Telephone Number	:	770-948-9088
Fax Number	:	770-948-9090

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. CAUDIA HILLS
Credential	:	LPC
Telephone Number	:	770-948-9088

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	07/30/2007

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Directions to “PURPOSE, INC ” Practice Location

Language	Start Address	Practice Location

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