Provider Demographics
NPI:1265005458
Name:PURE HEART PROVIDER & SITTER SERVICES, LLC
Entity Type:Organization
Organization Name:PURE HEART PROVIDER & SITTER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:504-417-4329
Mailing Address - Street 1:29547 HWY 11
Mailing Address - Street 2:
Mailing Address - City:PORT SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70083
Mailing Address - Country:US
Mailing Address - Phone:504-417-4329
Mailing Address - Fax:
Practice Address - Street 1:29547 HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:PORT SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70083-3039
Practice Address - Country:US
Practice Address - Phone:504-417-4329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA113866551OtherCONTRACTOR
LA11386651OtherMILITARY HEALTHCARE PROVIDER
LA11386651OtherHOME HEALTHCARE AGENCY