Provider Demographics
NPI:1750834669
Name:COMPASSIONATE NURSING AND HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:COMPASSIONATE NURSING AND HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TENESIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:901-453-6365
Mailing Address - Street 1:4384 STAGE RD
Mailing Address - Street 2:301
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-5794
Mailing Address - Country:US
Mailing Address - Phone:901-453-6365
Mailing Address - Fax:901-453-6378
Practice Address - Street 1:4384 STAGE RD
Practice Address - Street 2:STE. 301
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128
Practice Address - Country:US
Practice Address - Phone:901-453-6365
Practice Address - Fax:901-453-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN160001575253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care