Provider Demographics
NPI:1407592363
Name:COMPASSIONATE CARE COMPANION LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE COMPANION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WINFRED
Authorized Official - Last Name:COOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:440-714-1512
Mailing Address - Street 1:918 E GREEN ST UNIT A102
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-1455
Mailing Address - Country:US
Mailing Address - Phone:440-714-1512
Mailing Address - Fax:
Practice Address - Street 1:918 E GREEN ST UNIT A102
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-1455
Practice Address - Country:US
Practice Address - Phone:440-714-1512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care