Provider Demographics
NPI:1386452001
Name:YOUR PURPOSE HOME CARE, LLC
Entity type:Organization
Organization Name:YOUR PURPOSE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-755-4747
Mailing Address - Street 1:12844 LOMAS BLVD NE APT C6
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-6173
Mailing Address - Country:US
Mailing Address - Phone:505-539-9251
Mailing Address - Fax:505-600-3594
Practice Address - Street 1:12844 LOMAS BLVD NE APT C6
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-6173
Practice Address - Country:US
Practice Address - Phone:505-539-9251
Practice Address - Fax:505-600-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based