Provider Demographics
NPI:1417310863
Name:COMPASSIONATE HEART PERSONAL CARE & RESPITE SERVICES LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HEART PERSONAL CARE & RESPITE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-441-4337
Mailing Address - Street 1:373 JOE PITTMAN RD
Mailing Address - Street 2:
Mailing Address - City:FOXWORTH
Mailing Address - State:MS
Mailing Address - Zip Code:39483-4272
Mailing Address - Country:US
Mailing Address - Phone:601-441-4337
Mailing Address - Fax:601-633-5117
Practice Address - Street 1:425 OLD FOXWORTH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-8244
Practice Address - Country:US
Practice Address - Phone:601-441-4337
Practice Address - Fax:601-633-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care