MEDICARE: PURPOSE OF LIFE HOMECARE ARIZONA LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1942162482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURPOSE OF LIFE HOMECARE ARIZONA LLC

Provider Business Mailing Address
First Line	:	6300 RIVERSIDE PLAZA LN NW STE 118
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2617
Country	:	US
Telephone Number	:	800-375-1066
Fax Number	:	800-375-1066

Provider Business Practice Location Address
First Line	:	1616 E MAIN ST STE 236
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-9018
Country	:	US
Telephone Number	:	575-216-4212
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEONDRALIQUE GREENE
Credential	:
Telephone Number	:	817-404-6150

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	05/18/2026

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