Provider Demographics
NPI:1164149506
Name:COMPASSIONATE COMFORT CARE LLC
Entity Type:Organization
Organization Name:COMPASSIONATE COMFORT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IDOWU
Authorized Official - Middle Name:TOYIN
Authorized Official - Last Name:ADELOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-917-1009
Mailing Address - Street 1:3221 OAK RD APT WEST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1849
Mailing Address - Country:US
Mailing Address - Phone:410-917-1009
Mailing Address - Fax:
Practice Address - Street 1:3221 OAK RD APT WEST
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1849
Practice Address - Country:US
Practice Address - Phone:410-917-1009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health