Provider Demographics
NPI:1922858042
Name:COMPASSIONATE HEALTH CENTER LLC
Entity Type:Organization
Organization Name:COMPASSIONATE HEALTH CENTER LLC
Other - Org Name:DIVINE MED SPA & CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-343-2635
Mailing Address - Street 1:8684 GRIFFIN RD # 8B
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3713
Mailing Address - Country:US
Mailing Address - Phone:954-856-2364
Mailing Address - Fax:954-766-1819
Practice Address - Street 1:8684 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3713
Practice Address - Country:US
Practice Address - Phone:954-856-2364
Practice Address - Fax:954-766-1819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty