Provider Demographics
NPI:1023553740
Name:COMPASSIONATE UNIVERSAL AGENCY
Entity Type:Organization
Organization Name:COMPASSIONATE UNIVERSAL AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-736-8177
Mailing Address - Street 1:17375 HARPER AVE
Mailing Address - Street 2:UNIT 1580
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-7700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17375 HARPER AVE
Practice Address - Street 2:UNIT 1580
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-7700
Practice Address - Country:US
Practice Address - Phone:313-586-2144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health