NPIMap

Organization Active NPI

Purpose Driven Support Services

  • Community/Behavioral Health Agency
  • McDowell, KY
National Provider Identifier
1104556588
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PURPOSE DRIVEN SUPPORT SERVICES
Practice address
9575 Ky Route 122
McDowell, KY 41647-4164
Phone
(606) 359-0700
NPI assigned
Jun 16, 2022
Last updated
Mar 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PURPOSE DRIVEN SUPPORT SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Samantha StumboNPI 1609287226
Title
Owner
Phone
(606) 359-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9575 Ky Route 122
McDowell, KY 41647-4164

Mailing address

PO Box 41
MC Dowell, KY 41647-0041
Phone (606) 949-1623

National Provider Directory

National Provider Directory
Tax ID family
Purpose Driven Support Services4 organizations share this tax ID, including this one
Part of
Purpose Driven Support Services

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1104556588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41",
            "city": "MC DOWELL",
            "state": "KY",
            "postal_code": "416470041",
            "telephone_number": "606-949-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9575 KY ROUTE 122",
            "city": "MCDOWELL",
            "state": "KY",
            "postal_code": "416474164",
            "telephone_number": "606-359-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPOSE DRIVEN SUPPORT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PURPOSE DRIVEN SUPPORT SERVICES, LLC",
        "enumeration_date": "2022-06-16",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "STUMBO",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-359-0700"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDowell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.