Provider Demographics
NPI:1710435722
Name:COMPASSION, COMFORT & CARE
Entity Type:Organization
Organization Name:COMPASSION, COMFORT & CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KORTNEY
Authorized Official - Middle Name:MIRANDA
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN/ED
Authorized Official - Phone:229-942-3212
Mailing Address - Street 1:1304 LILY POND RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-7748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:229-883-9290
Practice Address - Street 1:1304 LILY POND RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-7748
Practice Address - Country:US
Practice Address - Phone:229-942-3212
Practice Address - Fax:229-883-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047-R-1464253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care