Provider Demographics
NPI:1295066744
Name:COMPASSION CARE CENTER, INC.
Entity type:Organization
Organization Name:COMPASSION CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-230-5574
Mailing Address - Street 1:2614 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3057
Mailing Address - Country:US
Mailing Address - Phone:310-230-5574
Mailing Address - Fax:323-298-7141
Practice Address - Street 1:2614 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-3057
Practice Address - Country:US
Practice Address - Phone:310-230-5574
Practice Address - Fax:323-298-7141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder