Provider Demographics
NPI:1427547660
Name:COMPASSIONATE CARE 1 HOME HEALTH
Entity Type:Organization
Organization Name:COMPASSIONATE CARE 1 HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PRACTICAL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:SOMI
Authorized Official - Last Name:JANET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-485-1055
Mailing Address - Street 1:9551 DEER TRACK RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7048
Mailing Address - Country:US
Mailing Address - Phone:513-485-1055
Mailing Address - Fax:
Practice Address - Street 1:9551 DEER TRACK RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7048
Practice Address - Country:US
Practice Address - Phone:513-485-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148675251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0072669Medicaid
OH=========Medicaid