Provider Demographics
NPI:1609280759
Name:COMPASSION HOME HEALTH CARE
Entity Type:Organization
Organization Name:COMPASSION HOME HEALTH CARE
Other - Org Name:COMPASSION HOME HEALTH CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA/MEDICATION AIDE
Authorized Official - Phone:336-809-1617
Mailing Address - Street 1:PO BOX 16405
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27416-0405
Mailing Address - Country:US
Mailing Address - Phone:336-809-1617
Mailing Address - Fax:336-851-2557
Practice Address - Street 1:1528 CONE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27416
Practice Address - Country:US
Practice Address - Phone:336-809-1617
Practice Address - Fax:336-851-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health