Provider Demographics
NPI:1578966404
Name:COMPASSION HOME HEALTH
Entity Type:Organization
Organization Name:COMPASSION HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED NURSE AIDE
Authorized Official - Phone:336-809-1617
Mailing Address - Street 1:PO BOX 16415
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27416-0415
Mailing Address - Country:US
Mailing Address - Phone:336-809-1617
Mailing Address - Fax:
Practice Address - Street 1:1528 LAWNDALE AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27400-0415
Practice Address - Country:US
Practice Address - Phone:336-809-1617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty