Provider Demographics
NPI:1811418270
Name:COMPASSIONATE HEARTS TRANSITIONAL HOUSING LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HEARTS TRANSITIONAL HOUSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-244-3217
Mailing Address - Street 1:20944 RIDGEMONT RD
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1168
Mailing Address - Country:US
Mailing Address - Phone:586-244-3217
Mailing Address - Fax:586-244-3217
Practice Address - Street 1:20944 RIDGEMONT RD
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1168
Practice Address - Country:US
Practice Address - Phone:586-244-3217
Practice Address - Fax:586-244-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI261QM0850XOtherTAXONOMY