Provider Demographics
NPI:1609826387
Name:COMPASSIONATE CARE HOME HEALTH
Entity Type:Organization
Organization Name:COMPASSIONATE CARE HOME HEALTH
Other - Org Name:COMPASSIONATE CARE HOME HEALTH AGENCY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCES
Authorized Official - Prefix:MRS
Authorized Official - First Name:KULJEET
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:KALEKA
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:559-432-2003
Mailing Address - Street 1:7545 N. DEL MAR AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6872
Mailing Address - Country:US
Mailing Address - Phone:559-432-2003
Mailing Address - Fax:559-449-0388
Practice Address - Street 1:7545 N DEL MAR AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6871
Practice Address - Country:US
Practice Address - Phone:559-432-2003
Practice Address - Fax:559-449-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000541251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08233FMedicaid
CAHHA08233FMedicaid