Provider Demographics
NPI:1225477292
Name:COMPASSIONATE CARE HOSPICE, LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MHCA
Authorized Official - Phone:402-612-6789
Mailing Address - Street 1:14805 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-5373
Mailing Address - Country:US
Mailing Address - Phone:402-612-6789
Mailing Address - Fax:402-894-1760
Practice Address - Street 1:1435 N 15TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-1133
Practice Address - Country:US
Practice Address - Phone:402-612-6789
Practice Address - Fax:402-894-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-22
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based