Provider Demographics
NPI:1891420998
Name:COLEMAN'S COMPASSIONATE CAREGIVER LLC
Entity Type:Organization
Organization Name:COLEMAN'S COMPASSIONATE CAREGIVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KURTISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:321-557-2691
Mailing Address - Street 1:396 DELMONICO ST NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3001
Mailing Address - Country:US
Mailing Address - Phone:321-557-2691
Mailing Address - Fax:
Practice Address - Street 1:396 DELMONICO ST NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3001
Practice Address - Country:US
Practice Address - Phone:321-557-2691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health