Provider Demographics
NPI:1437990363
Name:PURPLE LILY ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:PURPLE LILY ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-630-3678
Mailing Address - Street 1:312 KILGO ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-1651
Mailing Address - Country:US
Mailing Address - Phone:404-630-3678
Mailing Address - Fax:
Practice Address - Street 1:312 KILGO ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-1651
Practice Address - Country:US
Practice Address - Phone:404-630-3678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility