Provider Demographics
NPI:1942329453
Name:COMPASSIONATE CARE NURSING SERVICES
Entity Type:Organization
Organization Name:COMPASSIONATE CARE NURSING SERVICES
Other - Org Name:COMPASSIONATE HEALTHCARE NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMONA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:410-719-0672
Mailing Address - Street 1:5411 OLD FREDERICK RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2195
Mailing Address - Country:US
Mailing Address - Phone:410-719-0672
Mailing Address - Fax:410-719-0673
Practice Address - Street 1:5411 OLD FREDERICK RD
Practice Address - Street 2:SUITE 6
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2195
Practice Address - Country:US
Practice Address - Phone:410-719-0672
Practice Address - Fax:410-719-0673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411265200Medicaid