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Organization

PURPLE VINE REFUGE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOVELY MARIUS (PRESIDENT)
(786) 575-9130
Entity
Organization

Contact information

Practice address
861 NE 209TH TER APT 105, MIAMI, FL 33179-1226
(786) 575-9130
Mailing address
861 NE 209TH TER APT 105, MIAMI, FL 33179-1226
(786) 575-9130

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
251B00000X
Case Management Agency
Primary
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
10/23/2023
Last updated
11/14/2023
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