Provider Demographics
NPI:1164232534
Name:PURE PATH HOME CARE
Entity type:Organization
Organization Name:PURE PATH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:DANIELL
Authorized Official - Last Name:CHACON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-995-9779
Mailing Address - Street 1:500 E MAIN ST STE 1619
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2206
Mailing Address - Country:US
Mailing Address - Phone:757-995-9779
Mailing Address - Fax:
Practice Address - Street 1:500 E MAIN ST STE 1619
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2206
Practice Address - Country:US
Practice Address - Phone:757-995-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty