Provider Demographics
NPI:1508248287
Name:COMPASSIONATE CARE COMMUNITY HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMPASSIONATE CARE COMMUNITY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-485-6673
Mailing Address - Street 1:927 S. GOLDWYN AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805
Mailing Address - Country:US
Mailing Address - Phone:407-485-6673
Mailing Address - Fax:407-704-8106
Practice Address - Street 1:927 S. GOLDWYN AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805
Practice Address - Country:US
Practice Address - Phone:407-485-6673
Practice Address - Fax:407-704-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care