Provider Demographics
NPI:1790504579
Name:FIGHTING WITH PURPOSE LLC
Entity type:Organization
Organization Name:FIGHTING WITH PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANISEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-663-2229
Mailing Address - Street 1:1075 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-3805
Mailing Address - Country:US
Mailing Address - Phone:313-663-2229
Mailing Address - Fax:
Practice Address - Street 1:10341 MERLIN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-1947
Practice Address - Country:US
Practice Address - Phone:313-338-9136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty