Provider Demographics
NPI:1114624095
Name:COMPASSIONATE HOMECARE LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELSIE
Authorized Official - Middle Name:KAH
Authorized Official - Last Name:CHICK NTUMYUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-240-4629
Mailing Address - Street 1:510 NW JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8853
Mailing Address - Country:US
Mailing Address - Phone:515-240-4629
Mailing Address - Fax:
Practice Address - Street 1:510 NW JACKSON DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8853
Practice Address - Country:US
Practice Address - Phone:515-240-4629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities