Provider Demographics
NPI:1336901354
Name:CREATED WITH PURPOSE
Entity type:Organization
Organization Name:CREATED WITH PURPOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES-PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:267-231-1271
Mailing Address - Street 1:1121 S RUBY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-4822
Mailing Address - Country:US
Mailing Address - Phone:267-231-1271
Mailing Address - Fax:
Practice Address - Street 1:1121 S RUBY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-4822
Practice Address - Country:US
Practice Address - Phone:267-231-1271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care