Organization
BREATHE NEW LIFE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMIKA PURNELL (CEO)
(267) 597-7323
Entity
Organization
Contact information
Practice address
4311 BROWN ST, PHILADELPHIA, PA 19104-1321
(267) 597-7323
Mailing address
4311 BROWN ST, PHILADELPHIA, PA 19104-1321
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
302R00000X
Health Maintenance Organization
—
PA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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