Provider Demographics
NPI:1669956660
Name:AGING WITH PURPOSE LLC
Entity type:Organization
Organization Name:AGING WITH PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIASON
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:716-725-9671
Mailing Address - Street 1:1404 SWEET HOME RD STE 11
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2778
Mailing Address - Country:US
Mailing Address - Phone:716-235-3013
Mailing Address - Fax:716-235-5795
Practice Address - Street 1:1404 SWEET HOME RD STE 11
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2778
Practice Address - Country:US
Practice Address - Phone:716-235-3013
Practice Address - Fax:716-235-5795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty