Provider Demographics
NPI:1184323768
Name:CARING AND COMPASSIONATE SERVICES AT HOME
Entity type:Organization
Organization Name:CARING AND COMPASSIONATE SERVICES AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-982-8262
Mailing Address - Street 1:380 MARTIN LAKES DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32220-3747
Mailing Address - Country:US
Mailing Address - Phone:904-982-8262
Mailing Address - Fax:
Practice Address - Street 1:380 MARTIN LAKES DR W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32220-3747
Practice Address - Country:US
Practice Address - Phone:904-982-8262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services