Provider Demographics
NPI:1043829542
Name:PERPETUAL VENTURES. LLC
Entity type:Organization
Organization Name:PERPETUAL VENTURES. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-821-2012
Mailing Address - Street 1:7661 MCLAUGHLIN RD # 364
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4727
Mailing Address - Country:US
Mailing Address - Phone:719-323-6464
Mailing Address - Fax:719-627-4242
Practice Address - Street 1:12655 BLACK FOREST RD STE 178
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-1678
Practice Address - Country:US
Practice Address - Phone:719-323-6464
Practice Address - Fax:719-627-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty