Provider Demographics
NPI:1043954571
Name:COMPASSIONATE HEALTH OF CLERMONT LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HEALTH OF CLERMONT LLC
Other - Org Name:COMPASSIONATE HEALTH OF CLERMONT LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JHENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-256-5206
Mailing Address - Street 1:9350 US HIGHWAY 192 STE 104
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-8231
Mailing Address - Country:US
Mailing Address - Phone:863-256-5206
Mailing Address - Fax:863-913-0534
Practice Address - Street 1:9350 US HIGHWAY 192 STE 104
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-8231
Practice Address - Country:US
Practice Address - Phone:863-256-5206
Practice Address - Fax:863-913-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center