Provider Demographics
NPI:1922514793
Name:ZION COMPASSION CARE, LLC
Entity Type:Organization
Organization Name:ZION COMPASSION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ENOCK
Authorized Official - Middle Name:ASAMOAH
Authorized Official - Last Name:GYAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-233-2099
Mailing Address - Street 1:3560 W MESQUITE AVE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6597
Mailing Address - Country:US
Mailing Address - Phone:480-233-2099
Mailing Address - Fax:
Practice Address - Street 1:8257 E GUADALUPE RD STE 117
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-9636
Practice Address - Country:US
Practice Address - Phone:480-233-2099
Practice Address - Fax:480-245-1050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ660047OtherAHCCCS