Provider Demographics
NPI:1356504898
Name:COMPASSION COMMUNITY LIVING CENTER, LLC
Entity Type:Organization
Organization Name:COMPASSION COMMUNITY LIVING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:EZERA
Authorized Official - Last Name:NWOJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-277-1354
Mailing Address - Street 1:17631 BARTON POINT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2481
Mailing Address - Country:US
Mailing Address - Phone:281-277-1354
Mailing Address - Fax:
Practice Address - Street 1:17631 BARTON POINT LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2481
Practice Address - Country:US
Practice Address - Phone:281-277-1354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-04
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health