Provider Demographics
NPI:1629325964
Name:COMPASSIONATE CARES
Entity Type:Organization
Organization Name:COMPASSIONATE CARES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TWANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-500-0027
Mailing Address - Street 1:323 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:MS
Mailing Address - Zip Code:39083-2113
Mailing Address - Country:US
Mailing Address - Phone:601-500-0027
Mailing Address - Fax:601-894-6577
Practice Address - Street 1:323 JACKSON ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:MS
Practice Address - Zip Code:39083-2113
Practice Address - Country:US
Practice Address - Phone:601-500-0027
Practice Address - Fax:601-894-6577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS056032433747P1801X
MS02089343376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty