Provider Demographics
NPI:1912573452
Name:HEART OF PURPOSE FOUNDATION INC
Entity Type:Organization
Organization Name:HEART OF PURPOSE FOUNDATION INC
Other - Org Name:JB PROFESSIONAL SPORTS MED CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / ATHLETIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-781-0350
Mailing Address - Street 1:3330 N GALLOWAY AVE STE 304132
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4728
Mailing Address - Country:US
Mailing Address - Phone:469-781-0350
Mailing Address - Fax:
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3923
Practice Address - Country:US
Practice Address - Phone:469-781-0350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332U00000XSuppliersHome Delivered Meals
No333300000XSuppliersEmergency Response System Companies
No342000000XTransportation ServicesTransportation Network Company
No347C00000XTransportation ServicesPrivate Vehicle