Provider Demographics
NPI:1124535893
Name:KH COMPASSIONATE HEARTS HOME HEALTH, LLC
Entity Type:Organization
Organization Name:KH COMPASSIONATE HEARTS HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:336-682-0306
Mailing Address - Street 1:4509 LASLEY DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27105-3116
Mailing Address - Country:US
Mailing Address - Phone:336-986-4642
Mailing Address - Fax:
Practice Address - Street 1:4509 LASLEY DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-3116
Practice Address - Country:US
Practice Address - Phone:336-986-4642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care