Provider Demographics
NPI:1609626902
Name:PURE PEACE LLC
Entity Type:Organization
Organization Name:PURE PEACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CARE AFFILIATE
Authorized Official - Prefix:
Authorized Official - First Name:REINA
Authorized Official - Middle Name:ARIANA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:248-832-0223
Mailing Address - Street 1:25510 FOUNTAIN PARK DR W APT 278
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2562
Mailing Address - Country:US
Mailing Address - Phone:248-832-0223
Mailing Address - Fax:
Practice Address - Street 1:25510 FOUNTAIN PARK DR W APT 278
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2562
Practice Address - Country:US
Practice Address - Phone:248-832-0223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty