Provider Demographics
NPI:1477293058
Name:COMPASSIONATE ELDERCARE LLC
Entity Type:Organization
Organization Name:COMPASSIONATE ELDERCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:CLARK MORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:518-925-1318
Mailing Address - Street 1:123 PLEASANT VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKE LUZERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12846
Mailing Address - Country:US
Mailing Address - Phone:845-797-1899
Mailing Address - Fax:518-309-6267
Practice Address - Street 1:24 KOMAR DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:NY
Practice Address - Zip Code:12019
Practice Address - Country:US
Practice Address - Phone:845-797-1899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management