Provider Demographics
NPI:1053113373
Name:PERSEVERANCE PLACE LLC
Entity type:Organization
Organization Name:PERSEVERANCE PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:SHAUNA
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-558-1556
Mailing Address - Street 1:306 MARTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27249-8745
Mailing Address - Country:US
Mailing Address - Phone:336-558-1556
Mailing Address - Fax:
Practice Address - Street 1:306 MARTINGALE DR
Practice Address - Street 2:
Practice Address - City:GIBSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27249-8745
Practice Address - Country:US
Practice Address - Phone:336-558-1556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care