Provider Demographics
NPI:1386096683
Name:PURPOSE LIVING HOME CARE LLC
Entity type:Organization
Organization Name:PURPOSE LIVING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:609-321-4058
Mailing Address - Street 1:11691 HENRYETTA CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-4192
Mailing Address - Country:US
Mailing Address - Phone:609-321-4058
Mailing Address - Fax:
Practice Address - Street 1:11691 HENRYETTA CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-4192
Practice Address - Country:US
Practice Address - Phone:609-321-4058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEIN