Organization
PURE LIFE LLC
Active
Other names
Gods Country Primary Home Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFIQ R VIRANI (PRESIDENT)
(830) 426-2786
Entity
Organization
Contact information
Practice address
1705 19TH ST STE A, HONDO, TX 78861-2301
(830) 426-2786
(830) 426-4786
Mailing address
1705 19TH ST STE A, HONDO, TX 78861-2301
(830) 426-2786
(830) 426-4786
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
016337
TX
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016337
TX DEPARTMENT OF AGING AND DISABILITY PAS LICENSE
TX
01
—
3747P1801X
ADDITIONAL TAXONOMY CODE
TX
Enumeration date
03/18/2014
Last updated
03/14/2019
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