Provider Demographics
NPI:1710307277
Name:COMPASSIONATE HOME CARE
Entity Type:Organization
Organization Name:COMPASSIONATE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-769-1499
Mailing Address - Street 1:75-5660 KOPIKO ST
Mailing Address - Street 2:SUITE C-7 #112
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3611
Mailing Address - Country:US
Mailing Address - Phone:808-769-1499
Mailing Address - Fax:
Practice Address - Street 1:75-5660 KOPIKO ST
Practice Address - Street 2:SUITE C-7 #112
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3611
Practice Address - Country:US
Practice Address - Phone:808-769-1499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty