Provider Demographics
NPI:1285102137
Name:PURPLE DOVE COMMUNITY CARE AGENCY
Entity type:Organization
Organization Name:PURPLE DOVE COMMUNITY CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADJIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:347-331-9532
Mailing Address - Street 1:728 EAST 233 STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466
Mailing Address - Country:US
Mailing Address - Phone:347-899-8620
Mailing Address - Fax:347-899-8621
Practice Address - Street 1:728 EAST 233 STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:347-899-8620
Practice Address - Fax:347-899-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health