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Organization
PURAVIDA IN HOME THERAPY SERVICES, LLC
Active
Organization
PURAVIDA IN HOME THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELIZABETH VILLALOBOS-SCHOLD MOT/R (CEO/ADMINISTRATOR)
(413) 847-1212
Entity
Organization
Contact information
Practice address
16 CONVERSE CIRCLE, EAST LONGMEADOW, MA 01028
(413) 847-1212
Mailing address
16 CONVERSE CIRCLE, EAST LONGMEADOW, MA 01028
(413) 847-1212
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
225XH1300X
Human Factors Occupational Therapist
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083161145
—
MA
Enumeration date
04/29/2021
Last updated
07/03/2024
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