Provider Demographics
NPI:1831762673
Name:PATH OF PASSION HOMECARE LLC
Entity type:Organization
Organization Name:PATH OF PASSION HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS.
Authorized Official - Prefix:
Authorized Official - First Name:ESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-641-9208
Mailing Address - Street 1:45 HARDY COURT CTR STE 186
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-2501
Mailing Address - Country:US
Mailing Address - Phone:228-641-9208
Mailing Address - Fax:
Practice Address - Street 1:808 39TH AVE UNIT A
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-1432
Practice Address - Country:US
Practice Address - Phone:228-641-9208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty