Provider Demographics
NPI:1679124028
Name:COMPASSIONATE CARE SERVICES
Entity Type:Organization
Organization Name:COMPASSIONATE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAYOKUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYALE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:317-460-8801
Mailing Address - Street 1:5812 W HILLS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-6358
Mailing Address - Country:US
Mailing Address - Phone:317-460-8801
Mailing Address - Fax:574-334-1135
Practice Address - Street 1:5812 W HILLS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-6358
Practice Address - Country:US
Practice Address - Phone:317-460-8801
Practice Address - Fax:574-334-1135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASSIONATE HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-26
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care