Provider Demographics
NPI:1083088173
Name:COMPASSIONATE CARE CENTERS LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:KRISTINA
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-695-7392
Mailing Address - Street 1:4494 W PEORIA AVE
Mailing Address - Street 2:SUITE 115A
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-2023
Mailing Address - Country:US
Mailing Address - Phone:623-878-5800
Mailing Address - Fax:623-773-2274
Practice Address - Street 1:4494 W PEORIA AVE
Practice Address - Street 2:SUITE 115A
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-2023
Practice Address - Country:US
Practice Address - Phone:623-878-5800
Practice Address - Fax:623-773-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Single Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty