Provider Demographics
NPI:1346917267
Name:DONNIE'S COMPASSIONATE FAMILY CARE HOME LLC
Entity Type:Organization
Organization Name:DONNIE'S COMPASSIONATE FAMILY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-219-2262
Mailing Address - Street 1:3879 HODGES DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-8737
Mailing Address - Country:US
Mailing Address - Phone:352-219-2262
Mailing Address - Fax:
Practice Address - Street 1:3879 HODGES DAIRY RD
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379-8737
Practice Address - Country:US
Practice Address - Phone:352-219-2262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home