Provider Demographics
NPI:1699324772
Name:PURPOSE HEALING CENTER, LLC
Entity type:Organization
Organization Name:PURPOSE HEALING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMAENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-267-8491
Mailing Address - Street 1:9332 N 95TH WAY STE B203
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6885 E PINNACLE VISTA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-8739
Practice Address - Country:US
Practice Address - Phone:480-579-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PURPOSE HEALING CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-10
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility