Provider Demographics
NPI:1942899398
Name:DEVINE PURPOSE FOR SENIORS LLC
Entity Type:Organization
Organization Name:DEVINE PURPOSE FOR SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:EUNICE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-420-5490
Mailing Address - Street 1:PO BOX 13501
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45413-0501
Mailing Address - Country:US
Mailing Address - Phone:850-420-5490
Mailing Address - Fax:
Practice Address - Street 1:2641 HIBISCUS WAY APT 300
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2398
Practice Address - Country:US
Practice Address - Phone:850-420-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health