Organization
PURPLE PASSION ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLYN MOORE LMHC, NCC (PRESIDENT)
(863) 557-3944
Entity
Organization
Contact information
Practice address
5045 E HINSON AVE, HAINES CITY, FL 33844-8872
(863) 557-3944
Mailing address
5045 E HINSON AVE, HAINES CITY, FL 33844-8872
(863) 557-3944
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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