Provider Demographics
NPI:1861254914
Name:PASSION ON PURPOSE LLC
Entity type:Organization
Organization Name:PASSION ON PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:951-790-8410
Mailing Address - Street 1:3633 E YEAGER CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1611
Mailing Address - Country:US
Mailing Address - Phone:951-790-8410
Mailing Address - Fax:
Practice Address - Street 1:3635 E INVERNESS AVE STE 109
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3848
Practice Address - Country:US
Practice Address - Phone:951-790-8410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty