Provider Demographics
NPI:1053065110
Name:PCAH COMPASSIONATE CARE, LLC
Entity Type:Organization
Organization Name:PCAH COMPASSIONATE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:RISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-427-2790
Mailing Address - Street 1:2709 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7537
Mailing Address - Country:US
Mailing Address - Phone:407-399-5541
Mailing Address - Fax:
Practice Address - Street 1:200 WESTSIDE SQ STE 605
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5064
Practice Address - Country:US
Practice Address - Phone:256-427-2790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care