Provider Demographics
NPI:1003293937
Name:COMPASSION CREST LLC
Entity Type:Organization
Organization Name:COMPASSION CREST LLC
Other - Org Name:COMPASSION CREST HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-385-0920
Mailing Address - Street 1:1312 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1638
Mailing Address - Country:US
Mailing Address - Phone:702-385-0920
Mailing Address - Fax:702-474-6340
Practice Address - Street 1:2551 S FORT APACHE RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8700
Practice Address - Country:US
Practice Address - Phone:702-385-0920
Practice Address - Fax:702-518-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7898PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care