Provider Demographics
NPI:1134459951
Name:COMPASSIONATE HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSEGUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELEKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-650-6613
Mailing Address - Street 1:1452 AYLESBURY DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-8215
Mailing Address - Country:US
Mailing Address - Phone:706-650-6613
Mailing Address - Fax:
Practice Address - Street 1:1452 AYLESBURY DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-8215
Practice Address - Country:US
Practice Address - Phone:706-650-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-29
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036-R-0665253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care