Provider Demographics
NPI:1104429737
Name:COMPASSIONATE INNOVATIONS LLC
Entity type:Organization
Organization Name:COMPASSIONATE INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-844-2814
Mailing Address - Street 1:147 21ST ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3907
Mailing Address - Country:US
Mailing Address - Phone:330-844-2814
Mailing Address - Fax:330-880-0333
Practice Address - Street 1:3154 LINCOLN WAY NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-5207
Practice Address - Country:US
Practice Address - Phone:330-844-2814
Practice Address - Fax:330-880-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0109654Medicaid