Provider Demographics
NPI:1083372676
Name:TRACEE'S HOME OF COMPASSION
Entity Type:Organization
Organization Name:TRACEE'S HOME OF COMPASSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACEE
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-740-2474
Mailing Address - Street 1:562 BLUE PONT TER
Mailing Address - Street 2:APT F
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602
Mailing Address - Country:US
Mailing Address - Phone:757-740-2474
Mailing Address - Fax:
Practice Address - Street 1:562 BLUE POINT TERRACE
Practice Address - Street 2:APT F
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602
Practice Address - Country:US
Practice Address - Phone:757-740-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health