Provider Demographics
NPI:1023699626
Name:PURPLE ORCHID HOME CARE SERVICES, INC.
Entity type:Organization
Organization Name:PURPLE ORCHID HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALVATINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:386-276-9001
Mailing Address - Street 1:381 PALM COAST PKWY SW UNIT 4
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-4782
Mailing Address - Country:US
Mailing Address - Phone:386-276-9001
Mailing Address - Fax:386-585-4402
Practice Address - Street 1:381 PALM COAST PKWY SW UNIT 4
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4782
Practice Address - Country:US
Practice Address - Phone:386-276-9001
Practice Address - Fax:386-585-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health