Provider Demographics
NPI:1023308996
Name:CARING & COMPASSIONATE HEALTHCARE AGENCY LLC
Entity type:Organization
Organization Name:CARING & COMPASSIONATE HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REMONA
Authorized Official - Middle Name:LYSA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-329-3531
Mailing Address - Street 1:1815 ELEANOR ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-1817
Mailing Address - Country:US
Mailing Address - Phone:507-329-3531
Mailing Address - Fax:507-343-0076
Practice Address - Street 1:2860 JOLLY RD STE B
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3669
Practice Address - Country:US
Practice Address - Phone:507-329-3531
Practice Address - Fax:507-343-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1023308996Medicaid
MI1023308996Medicaid