Provider Demographics
NPI:1922879436
Name:PURPOSE BEHAVIORAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:PURPOSE BEHAVIORAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:PRETINA
Authorized Official - Middle Name:LAROSA
Authorized Official - Last Name:HUTCHINSON ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:352-792-4241
Mailing Address - Street 1:315 N MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:STARKE
Mailing Address - State:FL
Mailing Address - Zip Code:32091-3026
Mailing Address - Country:US
Mailing Address - Phone:352-792-4241
Mailing Address - Fax:
Practice Address - Street 1:733A OAK ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-2337
Practice Address - Country:US
Practice Address - Phone:352-792-4241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)