Provider Demographics
NPI:1245338722
Name:COMPASSIONATE CARE HOME HEALTH SERVICES, INC
Entity type:Organization
Organization Name:COMPASSIONATE CARE HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:EZRA
Authorized Official - Last Name:FERNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-345-7801
Mailing Address - Street 1:515 PROGRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9382
Mailing Address - Country:US
Mailing Address - Phone:989-345-7030
Mailing Address - Fax:989-345-7050
Practice Address - Street 1:515 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9382
Practice Address - Country:US
Practice Address - Phone:989-345-7030
Practice Address - Fax:989-345-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4491382Medicaid
MI4468910Medicaid
MI4491346Medicaid
MI4491391Medicaid
MI4491373Medicaid
MI4491364Medicaid