Provider Demographics
NPI:1437610417
Name:COMPASSIONATE HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:COMPASSIONATE HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENDRIA
Authorized Official - Middle Name:DONALLE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-243-9753
Mailing Address - Street 1:18 S 9TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1630
Mailing Address - Country:US
Mailing Address - Phone:570-243-9753
Mailing Address - Fax:
Practice Address - Street 1:18 S 9TH ST STE 104
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1630
Practice Address - Country:US
Practice Address - Phone:570-243-9753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-31
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103998880-0001Medicaid